Purpose of the Financial Assistance Program
RPRD Diagnostics, LLC (“RPRD”) offers a Financial Assistance Program (“FAP”) to eligible patients who are unable to pay for the full amount of the deductible, copayment and/or coinsurance bill relating to the testing services they receive.
Subject to satisfying the eligibility criteria described below, RPRD may reduce the patient’s total out-of-pocket financial responsibility to $380.00. Patients are expected to cooperate with RPRD’s procedures for completing an application form and supplying other information to determine eligibility (as described below), and to contribute to the cost of their care based on their individual ability to pay.
Patients must satisfy the following eligibility criteria to qualify for the FAP, and such determinations are made by RPRD in its sole discretion.
- Patient received the testing service at RPRD.
- Patient has commercial health insurance.
- Patient is unable to pay for the deductible, copayment and/or coinsurance bill of the testing services they receive.
- Patient authorizes RPRD to bill the patient’s insurance payer(s) for the testing service received.
- Patient is a resident of the United States.
- Patient’s household income is below 500% of the Federal Poverty Guidelines in effect the year that the services were rendered to the patient.
- Patient shall provide accurate information in the application process.
Patients can apply for FAP prior to or during the ordering and testing process. If approved, a final bill from RPRD will reflect the adjusted amount owed.
Financial assistance is not available for the governmental health plans, such as Medicare, Medicaid, or self-pay.
500% of the Federal Poverty Guidelines in 2021Note: For families/households with more than 8 persons, add $4,540 for each additional person.
|Persons in family/household||Federal Poverty Guideline||500% of the Federal Poverty Guidelines|
How to Apply for Financial Assistance
Patients can obtain an FAP application (the “Application”) at no charge by contacting RPRD’s Patient Financial Services at (414) 316-3097, or by downloading and printing the Application.
Patients must complete and return the Application, together with the required documents (collectively, the “FAP Documents”) that provide RPRD with the minimum information necessary to consider a patient’s eligibility for the FAP.
Do not send originals. All the documents submitted to RPRD will be scanned and shredded.
Patients must return the completed Application and the FAP Documents to RPRD either by email to email@example.com or by first class U.S. mail to:
RPRD Diagnostics, LLC
c/o Patient Financial Services
1225 Discovery Parkway, Suite 260
Milwaukee, WI 53226
RPRD reserves the right to request additional information before approving the patient’s request for assistance under the FAP. Patient will be notified of RPRD’s decision regarding the request for financial assistance in writing approximately thirty (30) days after RPRD’s receipt of a completed Application and the FAP Documents (and any other documents or information requested by RPRD).