Participating Providers

• Comprehensive Neurotrauma Assessments are performed by participating neurologists, neuro-intensivists, and other qualified neurologic subspecialists who:
• Have specialized experience in the diagnosis and management of traumatic brain injury
• Have completed pathway-specific training regarding biomarker-informed neurotrauma evaluation
• Maintain all required professional licenses and credentials in the patient's state of care

Medical Services Provided

• Participating Providers independently evaluate each patient and determine the appropriate course of medical care based upon their professional judgment and the patient's clinical presentation. Services may include:
• Comprehensive neurotrauma evaluation and written clinical report
• Assessment of neurological symptoms, functional impairment, and injury history
• Ordering of medically necessary diagnostic testing when clinically indicated
• Development of diagnostic and treatment recommendations based on the provider's independent medical judgment

The Participating Provider independently determines whether biomarker testing, neuroimaging, neuropsychological testing, specialist referral, or other diagnostic modalities are medically appropriate. Any recommended testing, treatment, or follow-up care will be documented within the provider's clinical records.

All Professional Services are billed by the treating or consulting provider.

Included Pathway Support

When services are provided through a Participating Provider in the BioConnetiX TBI Biomarker Pathway, BioConnetiX may provide administrative coordination services that include:

• Appointment scheduling and care coordination
• Predictable and standardized billed charges for pathway-included services and CPT-coded procedures, regardless of which Participating Provider performs the service within the applicable BioConnetiX Pathway and Channel Program
• Coordination of Letters of Protection (LOPs) or Direct-Pay Agreements, where applicable
• Centralized coordination of medical records, reports, and billing documentation

BioConnetiX does not practice medicine and does not direct, influence, or control the independent medical judgment of any Participating Provider.

-- If Medically Necessary and Ordered --

Participating Laboratories

Biomarker testing is performed by CLIA-certified Participating Laboratories that:

• Offer laboratory tests that have been reviewed by the Clinical Advisory Board (CAB) as aligned with the BioConnetiX TBI Biomarker Pathway
• Perform laboratory testing pursuant to orders issued by the patient's treating provider

Laboratory Services Provided

Participating Laboratories independently perform ordered laboratory testing and generate laboratory results in accordance with applicable laboratory standards and regulatory requirements.

The selection of laboratory tests remains the independent medical decision of the ordering provider. Participating Laboratories do not determine whether testing is medically necessary and perform testing only pursuant to valid provider orders.

All Laboratory Testing Services are billed by the clinical laboratory.

Included Pathway Support

When laboratory tests are ordered through a Participating Laboratory in the BioConnetiX TBI Biomarker Pathway, BioConnetiX may provide administrative coordination services that include:

• Appointment coordination for patient's lab draw (phlebotomy)
• Predictable and standardized billed charges for pathway-included services and CPT-coded procedures, regardless of which Participating Laboratory performs the service within the applicable BioConnetiX Pathway and Channel Program
• Coordination of Letters of Protection (LOPs) or Direct-Pay Agreements, where applicable
• Centralized coordination of medical records, reports, and billing documentation

Participating Providers

Interpretive reports are prepared by Participating Providers who:

• Maintain all required professional licenses and credentials
• Possess relevant expertise in pathology, neurocritical care, or other applicable specialties
• Have completed pathway-specific training regarding biomarker-informed neurotrauma assessment
• Independently evaluate available clinical and diagnostic information

Medical Services Provided

Participating Physicians independently review available clinical information, diagnostic testing results, and supporting medical records to prepare a written interpretive report. Services may include:

• Review of laboratory testing results
• Clinical interpretation of diagnostic findings within the context of the patient's reported injury and symptoms
• Preparation of a written interpretive report documenting observations, findings, and clinical impressions

All Professional Services are billed by the treating or consulting provider.

Included Pathway Support

When interpretive services are performed through a Participating Provider in the BioConnetiX TBI Biomarker Pathway, BioConnetiX may provide administrative coordination services that include:

• Coordination of specialist and records required for interpretation
• Predictable and standardized billed charges for pathway-included services and CPT-coded procedures, regardless of which Participating Provider performs the service within the applicable BioConnetiX Pathway and Channel Program
• Coordination of Letters of Protection (LOPs) or Direct-Pay Agreements, where applicable
• Centralized coordination of physician reports, laboratory reports, medical records, and billing documentation

BioConnetiX does not prepare medical opinions, interpret diagnostic findings, or direct, influence, or control the independent medical judgment of any Participating Physician.

-- If Consultation is Requested by a Treating Provider --

Participating Providers

• Physician pathologist with expertise in TBI-related biomarkers
• Provides consultative pathology services at the request of a treating or interpreting provider
• Reviews laboratory data and prior interpretive findings to address specific clinical questions posed by the requesting provider
• Preparation of a written consultative pathology opinion

The Participating Pathologist independently determines the scope of review, findings, conclusions, and recommendations contained within any consultative report.

Professional services billed separately by the consulting provider.

• Specialist Coordination
• Coordination of Letter of Protection (LOP) or Direct-Pay Agreement for pathology consultation services
• Medical and billing records sourcing and delivery

Included Pathway Support

When pathology consultation services are requested through the BioConnetiX TBI Biomarker Pathway, BioConnetiX may provide administrative coordination services that include:

• Coordination between applicable providers
• Coordination of records required for pathologist review
• Predictable and standardized billed charges for pathway-included services and CPT-coded procedures, regardless of which Participating Provider performs the service within the applicable BioConnetiX Pathway and Channel Program
• Coordination of Letters of Protection (LOPs) or Direct-Pay Agreements, where applicable
• Centralized coordination of physician reports, laboratory reports, medical records, and billing documentation

BioConnetiX does not provide pathology services and does not direct, influence, or control the independent professional judgment of any consulting pathologist.

-- If Consultation is Requested by a Treating Provider --

Participating Specialist

• Participating Providers with specialized expertise in traumatic brain injury, neurotrauma, neurocritical care, neurology, or related disciplines.

Medical Services Provided

When requested by a treating provider, a Participating Specialist may provide provider-to-provider consultation regarding the evaluation, management, and follow-up of patients with suspected or confirmed traumatic brain injury. Services may include:

• Clinical decision support
• Multidisciplinary care-planning consultation
• Guidance regarding additional diagnostic evaluation when clinically appropriate
• Guidance regarding follow-up testing intervals and monitoring strategies when clinically appropriate
• Recommendations regarding specialist referral or additional evaluation

The consulting specialist exercises independent professional judgment and provides recommendations solely to the requesting provider. The treating provider remains responsible for all patient care decisions.

Professional services are billed separately by the consulting provider.

Included Pathway Support

When subspecialty eConsult services are requested through the BioConnetiX TBI Biomarker Pathway, BioConnetiX may provide administrative coordination services that include:

• Coordination between applicable providers
• Coordination of records required for specialist review
• Predictable and standardized billed charges for pathway-included services and CPT-coded procedures, regardless of which Participating Provider performs the service within the applicable BioConnetiX Pathway and Channel Program
• Coordination of Letters of Protection (LOPs) or Direct-Pay Agreements, where applicable
• Centralized coordination of medical records and billing documentation

BioConnetiX does not provide medical consultations and does not direct, influence, or control the independent professional judgment of any consulting specialist.