Keep your scanners running. We handle the supervision. Physician-owned, safety-first, CMS compliant remote supervision with proprietary HIPAA-compliant technology.
Three reasons we're different from staffing agencies and tech wrappers
An idle scanner is a leak in your revenue
Eliminate the cost of on-site radiologists for contrast coverage. Use our on-demand, physician-led remote teams to cover weekends, evenings, and overflow. No more canceled appointments or lost revenue.
Compliance isn't just a checkbox; it's patient safety
Unlike private equity-backed competitors, our protocols were written by physicians. We understand the risks of contrast reactions, and our proprietary app ensures we are there the second you need us.
No friction. Just coverage.
Easy integration. Our Standard Safety Protocol fits seamlessly into your existing workflow. One click on our HIPAA-compliant app connects you to a supervising physician immediately.
See exactly how much idle scanners are costing your facility
Access our proprietary HIPAA-compliant platform with a single click
ACR-aligned workflow that integrates seamlessly with your existing procedures
Real-time audio/video supervision from experienced, board-certified physicians
To Our Colleagues in the Imaging Community:
We know the headache.
We know what it's like to watch a schedule fall apart because of a staffing gap. We know the pressure of trying to maintain high operational margins while navigating an increasingly complex regulatory environment. And we certainly know the frustration of relying on technology that feels like it was built by people who have never set foot in a clinic.
We founded Total Relief MD because we saw a gap in the market that "staffing agencies" couldn't fill and "software companies" didn't understand.
The industry didn't need another Zoom integration. It needed a clinical safety net.
We approached this problem from two distinct but complementary angles:
The Scale Perspective: Having grown a single-provider practice into a multi-facility institution with dozens of physicians, we understand that scalability is survival. You cannot grow your imaging center if your contrast supervision relies on a single on-site provider. You need a system that grows with you—one that provides coverage for that 7:00 PM overflow scan just as easily as the 10:00 AM rush.
The Tech Perspective: In a world of "black box" medical software, we chose to build our own. We realized that for remote supervision to be safe, the technology had to be instantaneous and invisible. We architected the Standard Safety Protocol not just to meet compliance, but to exceed the speed of clinical decision-making.
Total Relief MD is the convergence of these two worlds: Clinical Scale and Technological Precision.
When you use our platform, you aren't just logging into an app. You are tapping into a physician-led ecosystem designed to protect your patients and protect your bottom line.
We don't just stand behind our product. We stand with you—as fellow physicians, business owners, and partners in your growth.
Sincerely,
Adeeb Dwairy, MD & Nathan Nguyen, MD
Co-Founders, Total Relief MD
Two Physicians. One Shared Vision. Total Relief MD wasn't founded by venture capitalists. It was founded by practicing physicians who understand the pressures of modern medicine.
Dr. Adeeb Dwairy represents the gold standard in clinical scaling and operational excellence. As a prominent Gastroenterologist in the Houston area, Dr. Dwairy has achieved what few physicians can claim: scaling a single-provider practice into a premier, multi-facility medical institution.
Starting as a solo practitioner, Dr. Dwairy built a clinical enterprise that now includes dozens of board-certified physicians serving thousands of patients across the region. This journey required mastering the delicate balance between high-volume efficiency and uncompromising patient safety—the very same challenge imaging centers face today.
At Total Relief, Dr. Dwairy oversees the clinical recruitment and quality assurance protocols. His experience in managing large-scale physician teams ensures that our remote supervision isn't just "staffing"—it is a structured, clinically rigorous department that integrates seamlessly with your facility.
Dr. Nathan Nguyen is the bridge between clinical necessity and technological innovation. A Board-Certified Family Medicine Physician and active software developer, Dr. Nguyen grew frustrated with the "black box" technology often sold to medical providers.
Rejecting off-the-shelf tools that didn't meet safety standards, Dr. Nguyen personally architected the Total Relief proprietary platform. He writes code with the mindset of a doctor: every feature must enhance safety, reduce friction, and work instantly when a patient is on the table.
His dual expertise ensures that Total Relief remains the only platform in the industry where the software is as medically sound as the doctors using it.
Real Doctors. Real Time. Total Relief.
We built our own technology because off-the-shelf tools weren't safe enough for our standards
Purpose-built medical supervision environment, not a Zoom integration. Instant connection to physicians with zero latency.
Military-grade encryption for all patient data and communications. Full HIPAA compliance with BAA included.
ACR-aligned contrast reaction protocols built directly into the platform. Real-time decision support for emergencies.
Automatic documentation of every supervision session. Full compliance reporting for CMS and state requirements.
Unlike competitors who wrap third-party tools, we control the entire technology stack—ensuring reliability, security, and compliance.
See a DemoFlexible plans that grow with your imaging center
Comprehensive physician-led supervision tailored to your facility's volume
Flexible contracts • No long-term commitment required
CMS 2026 Virtual Direct Supervision Guidelines
CMS permanently adopted "Virtual Direct Supervision" for contrast studies. You no longer need a physician physically in the office suite to bill for CT/MRI contrast studies. A qualified supervisor can be remote via real-time audio/video technology.
Source: CMS Calendar Year 2026 Physician Fee Schedule Final Rule (CMS-1832-F), 42 CFR § 410.32
Physicians (MD/DO) and Non-Physician Practitioners (NPs, PAs, CNSs) if allowed by state law. For Independent Diagnostic Testing Facilities (IDTFs), the supervisor must be proficient in both the performance and interpretation of the test.
Source: 42 CFR § 410.32(b)(3)
Two-way audio AND video in real-time is required. Audio-only (telephone) supervision is strictly forbidden. The supervisor must be able to see the patient and direct on-site staff during an emergency.
Source: CMS Final Rule 2026, 42 CFR § 410.32
Texas: Yes. Physician must be "immediately available" (can be virtual). Requires Standing Delegation Order (SDO) specifying contrast supervision.
Louisiana: Yes. Statute explicitly states physical presence is not required if telecommunication is available. Requires Collaborative Practice Agreement (CPA) for NPs or supervision documentation for PAs.
Texas: TAC Title 22, Part 9, Chapter 193 | Louisiana: LA R.S. 37:1360.22, LA Admin Code 46:XLV
Allowed: Radiologic Technologists (RT) and Registered Nurses (RN) with documented training and competency.
Not Recommended: LPNs/LVNs (restricted in Louisiana, requires specific certification in Texas).
Prohibited: Medical Assistants cannot administer diagnostic contrast agents.
On-site personnel must be able to: (1) Recognize contrast reactions, (2) Perform CPR (BLS certified), (3) Administer emergency medications under remote physician direction, and (4) Follow established emergency protocols.
Source: ACR Manual on Contrast Media (2025 Edition)
Our physicians are proficient in both performance and interpretation of diagnostic imaging. We provide real-time two-way audio/video supervision, maintain HIPAA-compliant communication, respond within 2 minutes, and provide comprehensive protocol review and staff training to ensure full CMS and state law compliance.
Yes. Texas facilities need Standing Delegation Orders (SDO). Louisiana facilities need Collaborative Practice Agreements (CPA) for NPs or supervision documentation for PAs. All facilities must document staff competency in contrast administration and emergency response.
Real feedback from facilities using Total Relief MD for remote supervision
"We were canceling 5-8 contrast scans every week due to physician coverage gaps. Total Relief MD solved that problem immediately. Our weekend overflow is now fully covered, and we've recovered over $90,000 in annual revenue."
"The CMS 2026 changes made remote supervision possible, but finding a compliant provider was the challenge. Total Relief MD made it seamless—their platform is faster than calling our on-site radiologist used to be."
"What sold me was that Total Relief is physician-owned. They understand the clinical side, not just the technology. When we had a patient with a contrast allergy history, the supervising physician handled it perfectly."
Download our comprehensive guide to virtual direct supervision compliance. Includes documentation requirements, staff training protocols, and state-specific guidelines for Texas and Louisiana.
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