Applicable Medical specialties


Our tests help diagnose patients with known CAD/hypercholesterolemia/hypertension especially with those of smoking and stroke history.

Diabetic Medicine

Our protocol helps to diagnose diabetes as well as other hidden diseases associated with diabetes including neuropathies and PAD.


Our test provides a good wellness tool for all patients with diabetes/thyroid/cholesterol issues.


Our service helps the gastroenterologist identify and quantify neuropathies associated with the autonomic nervous system and thus helpful in treating patients with abdominal pain, constipation, diarrhea or symptoms that follow irritable bowel.

General Practice

Good wellness tool for testing asymptomatic diseases in asymptomatic patients, 60% of adult patients qualify.

Geriatric Medicine

Our service is a good wellness tool for the geriatric physician in that all of their patient mix should qualify for testing. Elevated pulse wave pressures in ABI over the age of 70 correlate with increased risk of dementia.

Integrative Practice

Our service is a complete wellness tool that can easily be implemented into integrative practices.

Internal Medicine

Our service is a great wellness tool for testing hidden diseases in asymptomatic patients.  In addition, we help diagnose the root causes of complex symptomologies related to the cardiovascular and autonomic nervous system. 60% of adult patients qualify.

Nephrology (Kidney)

All patients with Stage III kidney disease qualify - the link is they have a higher risk for PVD.


All patients with neuropathies qualify for our service.  Our service helps the Neurologist objectively quantify the neuropathy.


Because OGBYN physicians often act as the primary care physician for women of childbearing age our service is a  good wellness platform to help identify hidden disease in asymptomatic patients.


Our service is a good wellness tool for ophthalmologists, especially in diabetes detection.


The P4P testing protocol has clinical relevance in the orthopedic space because it is a good wellness tool used pre-surgery to identify circulatory and diabetic issues.     

Pain Management

Pain management encompasses treating patients with pain and correctly identifying the pathology of that pain.  Our clinical tool helps to identify whether that pain is vascular or neuropathic, or both allowing the clinician to develop a more personalized approach to the patient's pain management. 


Good wellness tool especially due to lower leg issues and large number of diabetic patients;  pre-surgery tool.

Pulmonology, to incl. Sleep Disorders

The link between COPD and autonomic dysfunction and heart disease makes our service a useful diagnostic screening tool. 

Sports Medicine

Our service is a good wellness platform for the sports medicine physician.


P4P is a good screening/wellness tool pre-surgery for detecting peripheral vascular disease and cardio risk assessments. 


P4P helps rule out vascular causes of Erectile Dysfunction.

Weight Management

Our service is a good wellness tool for weight management physicians.  Most patients will likely qualify for our service because of the higher rates of diabetes/ thyroid/ cholesterol issues in overweight patients.

Wound Care

Excellent screening tool to determine arterial causes of lower extremity ulcers/wounds.

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(800) 298-8342

We Work with Organizations of every size


Solo Medical Practices

Better patient care and additional revenue to remain independent in a competitive market.



Our service helps independent physician groups remain competitive with a general preventative diagnostic assessments that leads to intra-IPA referrals (cardiology, endocrinology, CV testing, sleep testing, labs).


Multi-Specialty Groups

Besides offering a preventative diagnostic assessments that generates a new revenue stream with an existing patient base we offer a screening tool that leads to multiple referrals streams (e.g. cardiology, endocrinology, diabetes mgmt., CV testing, sleep testing, labs).


Hospitals and Healthcare Orgs

Reduce hospital subsidies of employed physician groups. Boosts the bottom line with an existing patient base. We provide preventative diagnostic assessments lness platform that creates new downstream revenue for the Hospital in areas like cardiology, sleep centers, labs, other specialties and surgical procedures to name a few.  

Provide Better Patient Care

  • Early Detection of Chronic Disease  in Asymptomatic Patients

  • Diagnose Complex Symptoms

  • Increase Patient Compliance with Treatments


All-in-One Onsite Service

Office workflow



Patient Completes Questionnaire



Our medical technician conducts tests.



Patient follow-up appointment scheduled



Pulse 4 Pulse submits claim on behalf of physician.



Physician receives all remitances.



Pulse 4 Pulse Invoices Practice for Service.

$0 Start-up Costs

  • No Capital Expenditure

  • No Training of Clinical Staff

  • No Burden for Billing Staff

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leading technology

  • State-of-the-art diagnostic medical device  testing the  cardiovascular and autonomic nervous system

  • FDA Cleared

  • Small office footprint

  • Portable mobile cart

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same day results

  • Physician portal for immediate results

  • Instant easy-to-interpret 4-page report

  • Secure cloud-based database

  • 40-Page archive report


qualified Technicians

  • Onsite technician

  • Employed by P4P

  • Screens patients

  • Schedules patients

  • Conducts Tests


full service   Billing 

  • Determine insurance eligibility

  • Submit claims

  • Resolve disputes

  • No additional cost to you

Increase Practice Revenue

  • $160-170 Net Revenue per Screening

  • Increase Office Visits by 15-20%

  • Downstream Revenue for Multi-Specialty Groups


3 Main Tests to Identify Asymptomatic Diseases

Billing and Insurance

Our service is accepted Medicare, Medicaid, and most major private insurance carriers.  We have many years of experience working with insurance companies and have expertise in successfully submitting claims and minimizing denials for the billing codes associated with our service.


We offer two options for billing.

Option 1

Pulse 4 Pulse provides expert billing liaison to practice that aggregates and simplifies the billing process. The practice bills through their existing system .

Option 2

Billing provided by Pulse 4 Pulse team via national platform AdvanceMD.

Billing Codes

There are up to 5 Billable Diagnostic Codes approved by Medicare, Medicaid, and most private payers.

  • Ankle Brachial Test (93923)

  • Autonomic Function Test (95921)

  • Sudomotor Test (95923)

  • Electrocardiogram (93040)

  • Pulse Oximetry (94761)

Additional Billing Code

  • Follow-up Office Visit (99214)


Sudomotor Test

  • The device stimulates the patient’s sweat glands by emitting a low voltage current through a glass plate.

  • Results for this test helps the physician determine if the patient is going to be at risk of vascular disease or neuropathy.


Autonomic Nervous System Test

  • We report the heart-rate variability with beat-to-beat blood pressure in the patient after deep-breathing, head-tilt and Valsalva maneuver tests and compare to base-line.

  • Many diseases of the nervous system identified.

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Ankle-Brachial Index Test

  • A measurement of the ratio of blood pressure of the upper and lower body.

  • Results indicate if the patient is suffering from vascular disease.

  • Ability to test the vascular system at the micro-level.


proven standards of care


Testing of the autonomic nervous system (ANS) is the recommended standard of care by the American Diabetes Association for patients with Type 1 and Type 2 diabetes.


The American Heart Association Practice Guidelines for the management of patients with peripheral artery disease include the measurements of ankle-brachial index (ABI) in adults over 50 years old with a history of smoking, diabetes, or circulation problems, and all adults over 70 years old.

Early detection is the key to successful treatment.