Partnership proposal · prepared for Linda & Alan

The channel SofPulse
has never had.

Three live patient surfaces, a 50-state async Rx engine, surgeon-side RTM documentation, and a VA federal beachhead — AKS-clean by construction. Fixed fee. Day 0 is whenever we sign.

Proposal narrationlisten
IThe problem

A clinically dominant device trapped behind a rep model.

Distribution is the only risk that matters.

The science is done — 57% post-op pain reduction, 50%+ narcotic use cut, 800% faster wound healing, zero side-effect signal across millions of treatments. Growth is stuck at rep headcount. The patient internet goes untouched.

The Class II Rx gate stops most patients cold.

A $500 device that could be nearly free with HSA pre-tax dollars reads as a $500 sticker plus a physician-paperwork hurdle. Most patients defer. The problem is solvable — it just requires a 50-state async Rx engine that doesn't exist in the current model.

Three patient demand pools go unserved.

Post-surgical recovery (47,000 opioid deaths annually), chronic MSK pain (OA and tendinopathy patients who've failed NSAIDs and cortisone), and CMS-covered wound care (G0329 since 2004 — most eligible patients still don't know). None of these are reached by a rep.

Surgeon-side RTM revenue sits on the table, unpitched.

tPEMF maps directly to Remote Therapeutic Monitoring: 98975 setup ($21.71), 98977 device supply 16–30 days ($40.08), 98980 treatment management first 20 min ($53.81) — roughly $115 per patient per protocol cycle under the surgeon's own NPI. Nobody is putting that math in front of surgeons.

RTM codes & documentation →

“Used it on my hand for 15 minutes — in 4–5 hours all the inflammation was gone. Excited to get mine.”

— a real SofPulse user, this week
IIThe deal

Three layers. One MSA. AKS-clean by construction.

Not a vendor arrangement. Equity-aligned, risk-sharing, with a compliance posture that holds under any healthcare attorney's review.

01

Exclusive DTC Distribution

Take-title wholesale

Heal Without takes title to SofPulse devices at wholesale, sells direct-to-consumer across all three demand surfaces — post-surgical, chronic MSK, wound care. Commercial risk lands on the distribution side, not SofPulse's balance sheet.

  • healwithout.com — post-surgical recovery (live + indexed)
  • healwithout.com/chronic-pain — OA + MSK (live + indexed)
  • healwithout.com/wounds — CMS G0329 covered (live + indexed)
  • 50-state async Rx + LMN via altru.care (Josh Emdur, DO)
  • HSA / FSA payment infrastructure — full pre-tax unlocking
02

Milestone-Vested Equity

Upside aligned to performance

Equity vests only as commercial milestones land — platform live, VA contract signed, units shipped. Dilution happens precisely when the company is worth more. Never before.

  • Milestone 1: platform live + first 100 units shipped
  • Milestone 2: VA pilot site under contract
  • Milestone 3: 1,200 cumulative units + RTM documentation flowing
  • Vesting schedule + percentages in the MSA
03

Fixed-Fee Floor

$5K / mo + $50 / unit — AKS-clean

The federal VA lines and clinical coordination require a separate, compliance-hardened fee structure. Every dollar is fixed, set in advance, FMV-justified — Anti-Kickback Personal Services safe harbor (42 CFR 1001.952(d)) by construction.

  • 42 CFR 1001.952(d): fixed, set in advance, FMV, written, ≥ 1 year, no per-referral tie
  • $5,000 / month platform license covers demand surfaces, Rx engine, RTM docs, reporting
  • $50 / unit flat admin fee covers payment processing, onboarding, physician coordination
  • VA federal beachhead via Linda's VISN-level connection
  • MD-signed surgeon outreach — 21K LinkedIn × NPI cross-match
IIIRTM — the surgeon incentive

~$115 per patient per protocol cycle. Surgeon's own NPI.

tPEMF maps directly to Remote Therapeutic Monitoring. The prescribing surgeon bills under their own NPI. Heal Without provides the documentation. Nobody is putting this math in front of surgeons today.

CPTDescription2026 CMS rateFrequency
98975Initial device setup + patient education$21.71One-time per episode
98977Device supply (MSK) — 16–30 days$40.08Per 30-day period
98980Treatment management — first 20 min$53.81Per 30-day period
Per-cycle total~$115per patient / 30-day cycle
01

Surgeon bills under their own NPI — revenue accrues to their practice, not SofPulse or SolvingHealth. Shown as a sales tailwind that drives re-prescribing.

02

During the 90-day global surgery period, the operating surgeon cannot separately bill RTM for Medicare patients (bundled into the surgical fee). RTM is available to: the PT / physiatrist / PCP as a co-managing provider, or the same surgeon for non-Medicare payers, or after the global period ends.

03

The SMS PROM engine (daily VAS via Twilio — 98%+ open rate, 45% reply rate, no app install) IS the qualifying patient-generated data layer RTM requires. Documentation flows the day the box ships.

04

New 2026 codes 98979 (treatment management 10–19 min, ~$26) and 98985 (device supply 2–15 days, ~$22) expand billing flexibility for shorter observation windows.

IVThe math at scale

$3.59M SofPulse net revenue on $600K in fees.

Conservative model at $500 device retail. Every fee is flat — no percentage-of-sale lines anywhere. Surgeon-side RTM revenue accrues to the prescribing practice, shown as a sales tailwind, not SofPulse revenue.

Year · rampUnitsSH feesSofPulse netRTM tailwind
Year 1
Avg 100 / mo — VA pilot + early DTC
1,200$120,000$478,800$138,720
Year 2
Avg 200 / mo — VA scale + DTC ramp
2,400$180,000$1,017,600$277,440
Year 3
Avg 400 / mo — surgeon referral compounding
4,800$300,000$2,095,200$554,880
3-yr cumulative8,400$600,000$3,591,600$971,040
$2.99M
SofPulse net position — $3.59M net on $600K fees over 3 years
$2,500 → $30
device acquisition cost: rep model → DTC slipstream
$971K
surgeon-side RTM tailwind (3-yr) — the re-prescribing incentive
VFirst 90 days

Day 0 is whenever we sign.

Day 0–30
Foundation
  • MSA + engagement letter executed (SolvingHealth ↔ SofPulse)
  • Healthcare counsel sign-off on AKS / Personal Services posture
  • VA-track outreach kickoff — Linda's VISN contact engaged
  • Async Rx workflow staged — altru.care intake live for SofPulse
  • FHIR endpoint scoped against SofPulse device-data schema
Day 31–60
First Plumbing
  • FHIR R4 endpoint live in staging — Device + Observation resources
  • RTM attestation packet auto-generates from device-data days
  • MD-signed surgeon outreach launches — top-250 NPI matches
  • VA pilot site identified, formulary conversation opened
  • SMS PROM engine live — first cohort receiving daily VAS
Day 61–90
Production
  • FHIR endpoint to production — first live patient cohort flowing
  • 21 CFR Part 11 audit-log path verified end-to-end
  • First per-unit admin fees invoiced against device shipments
  • VA pilot signed or scheduled for next quarter
  • Renewal conversation on 90-day track record, not a promise

The ask

Sign the engagement.
We start when paper's signed.

The relationship is qualified, the architecture is documented, and every surface you just saw is already in production. The fixed-fee floor ($5,000/month + $50/unit) keeps the federal lines clean — then we paper the exclusive distribution rights and the milestone-vested equity that shares the upside we build together.

The engagement
$5,000
/ month · platform license
$50
/ unit · flat admin fee
90-day initial term · month-to-month after · 30-day exit notice · fixed, set in advance, FMV — AKS Personal Services safe harbor by construction (42 CFR 1001.952(d))
AKS compliance deep dive →
Back to the full walkthrough

Confidential. Modeled at a $500 device retail — replace with SofPulse ASP for exact figures. RTM revenue accrues to the prescribing surgeon's practice, not SofPulse or SolvingHealth — shown as a sales tailwind, not booked revenue. RTM is subject to the 90-day global surgery period for Medicare patients; the PT / co-managing physician is the eligible billing provider during that window. Not indexed. Not for distribution.