Thank you for choosing PDR Clinics. We are committed to the success of your medical treatment and care. Your clear understanding of our Financial Policy is important to our relationship. If you have any questions or concerns, please contact our AR Department at 952-908-2700.
INSURANCE INFORMATION: We need complete and accurate information about your policy. We will submit claims to your health insurance for you. You are responsible for payment of any deductible, co-pays and co-insurance as determined by your insurance company. You are responsible to know your level of coverage. You are responsible for any amount or any services not covered by your insurer.
REVIEW YOUR “SCHEDULE OF BENEFITS: We urge you to review your insurance policy’s “Schedule of Benefits”. It will help you understand your “scheduled benefits” and the agreement you have with your insurance company. You should call your insurance company with any specific questions related to your policy relating to outpatient physical and occupational therapy benefits. You need to accurately verify and understand your policy’s deductible, co-payment, co-insurance, visit limitations, effective annual calendar renewal date, and any pre-authorization and referral requirements. As a courtesy, we will also verify your coverage, but we are not able to guarantee the accuracy of the information we receive. Your insurance policy is a contract between you and your insurance company. You are responsible to know your level of coverage and you are ultimately responsible for the full payment of your bill.
☐ CO-PAYMENTS: Co-pays are due at the time of service. A $15.00 processing fee (or service fee) will be charged in addition to your co-payment if the co-payment is not paid at the time of service or by the end of the next business day. Patients have the option to leave a valid credit card on file* for co-payments to be charged the next business day. Patients with a valid credit card on file are exempt from the processing fee.
☐ EARLY MORNING &EVENING APPOINTMENTS WITH COPAYS: PDR requires a valid credit card on file* for co-payments when a patient is scheduled for an appointment before 8:00am, after 4:00pm and/or on weekends. If you are unable to leave a credit card on file, checks will be accepted at the time of service.
☐ CREDIT CARD POLICY FOR PATIENTS WITH HIGH DEDUCTIBLE HEALTH PLANS AND CO-INSURANCE: If you participate with a high-deductible health plan and/or co-insurance plan and you have not met your deductible, PDR requires a copy of your HSA/ debit card or a personal credit card to remain on file*. Your credit card will not be charged until after the services have been processed by your health insurance carrier and the balance has been deemed your responsibility. If you have met your deductible, you must show proof by bringing in a past EOB or like document. You will receive a statement and your credit card will be charged the amount on your statement on the last business day of each month. Do not send payment if you have a credit card on file.
☐ SELF-PAY: Self-pay is for patients without health insurance. PDR does offer a discount for cash payment at the time of service. Please note that payment in full is required at the time of service.
☐ CANCELLATION / NO SHOW: Due to increased demands for services, PDR requires a 24-hour, or more, notice for the cancellation of appointments. “No-shows” and appointments cancelled with “less than a 24-hour notice” will be charged $40.00. Your credit card will be charged accordingly the next business day. If you object to a “no-show” charge, you will need to submit an appeal in writing within 30 days of occurrence. You can mail your appeal letter to PDR, Attn: Appeals, 6700 France Ave S, Ste 230, Edina, MN 55435.
* A patient who fails to arrive for a scheduled appointment without cancelling the appointment at least 24 hours prior to the scheduled time is considered “no-show”. A patient who fails to present themselves two times for a scheduled appointment will only be able to schedule same day appointments. A patient that “no-shows” three or more times may be dismissed from PDR’s program.
☐ Participants in our Maintenance Program that “no-show” are responsible for the cost of their scheduled appointment of $25 per 15 minutes of scheduled time. Your credit card will be charged accordingly the next business day.
☐ WORKERS COMPENSATION: If you are being seen under a worker’s compensation claim, we are required to obtain authorization from your case adjuster or case manager prior to being seen. If primary liability is denied by the w/c carrier and payment is denied, we will file the claim with your personal health insurance policy. You are ultimately responsible for all balance due after insurance pays. If WC approves treatment, we will work with your attorney to resolve any balance due (only if WC approved treatment).
☐ PERSONAL INJURY, LIABILITY, AUTO, OR INVOLVEMENT OF AN ATTORNEY:
- Acceptance of Auto/Personal Injury Patients: We accept patients with “OPEN” cases only.
- If your Auto case is closed, exhausted or benefits denied due to IME (independent medical exam) we will bill your health insurance. If you are responsible for copayments it will be due at the time of service. If you are responsible for a deductible or co-insurance you may be required to leave a valid credit card on file. However, payment is due upon receipt of PDR’s monthly statement.
- Balance over 60 days will incur a 7% finance charge.
- We will bill your auto insurance for services rendered.
- If services are denied by your auto insurance we will bill your health insurance (if any).
- If your auto insurance denies treatment and you do not have health insurance:
- You (the patient) will be responsible for all balance due and will be required to pay at the time service is rendered.
- If the patient has an attorney (no health insurance), PDR may work with the attorney to obtain payment once the case is settled.
- If your health insurance applies payment to deductible, co-payment, or co-insurance, you (patient) will be responsible for 100% of that amount.. Due to health insurance contract, PDR cannot offer discounts on co-payment, deductible and/or co-insurance.
- Six Month Policy: PDR may hold select cases in litigation for 6 months but no more than a year. After six months, patients will be directly responsible for their medical bills. Payment plan arrangement can be made and will be subject to a 7% finance charge for all balance over 60 days.
- PDR will not hold any balance that represents deductibles/co-insurance, and or co-payments.
☐ PAYMENTS: We accept cash, check, Visa, MasterCard, American Express, Discover, Debit and HSA cards. You can also pay your bill online by logging onto your account at https://portal.pdrclinics.com. There is a $25.00 service charge for all returned checks.
☐ PAYMENT PLAN: Please contact the PDR business office if you are having difficulty paying your bill in full. We may be able to help by setting up a monthly payment plan. Please contact your AR representative.
☐ STATEMENTS: Statements will be mailed out monthly. Payment is due upon receipt of the statement. If you are unable to pay the balance in full, please contact the PDR billing department. There is a 7% finance charge for all balance over 60 days.
☐ OUTSTANDING BALANCE: PDR reserves the right not to see patients with outstanding balances of $300.00 or more, and who are not making regular payments on the balance due. PDR requires patients to keep their account in “good standing” while treating. If your account balance goes beyond 60 days, a 7% finance charge will be added to any unpaid balance.
☐ DELINQUENT ACCOUNT/COLLECTION: PDR will exhaust all efforts to help avoid sending a patient’s account to
collection. However, patients with a delinquent balance are required to make payment in full for future services. A delinquent account is defined as a patient balance in excess of 90 days if the patient has not made any payment and failed to set up a payment plan. If such payment is not made, services may be refused and your account may be forwarded to a collection agency.
* PDR’s billing module is through Kryptiq. Kryptiq is compliant with the Payment Card Industry’s Data Security Standards (PCI DSS for short), as is their processing partner PayPros (Payment Processing, Inc.). Though Kryptiq does not store or index cardholder information, and undergoes annual auditing to maintain PCI compliance, and make every effort to ensure the safety of the data they transfer. Kryptiq’s chosen processing partners are industry leaders in fraud monitoring, loss prevention, and implementation of the latest Payment Card Industry standards for data security.