Opencare Prime Billing Policy
Opencare bills for each Prime Appointment that occurred with a Prime Provider during a Billing Cycle, at the set Price.
Opencare assumes that all requests submitted by patients through the Opencare platform for Prime Providers will be successfully completed as Prime Appointments, unless the Provider indicates otherwise (either by cancelling the request or by marking a scheduled patient as a no show).
Prime Provider Criteria
We consider a provider a "Prime Provider" when they meet ALL of the following criteria:
- The provider has been approved as "Prime Eligible" by Opencare.
- The provider has an active, valid credit card associated with their profile.
Prime Appointment Criteria
We consider an appointment a "Prime Appointment" when it meets ALL of the following criteria:
- The patient submits their appointment request with a Prime Provider using the Opencare platform,
- AND the patient did NOT arrive at Opencare via a “Book Online” button featured on a practice or provider website (note that requests submitted by patients who arrive at Opencare via word of mouth referral may qualify as Prime Appointments),
- AND the patient has NOT visited this practice within the past 2 years,
- AND the patient is 18 years of age or older,
- AND the patient received treatment at the first instance or following a free consultation scheduled through Opencare (e.g. emergency treatments, checkups and/or cleanings, comprehensive exams all qualify as Prime Appointments),
- AND the patient is NOT on an HMO plan or government-funded social assistance program (e.g. Medicare/Medicaid in the US or ODSP in Canada).
- The Price will be made clear to the customer before activating a Prime Provider.
If for some reason there is a Price change agreed upon by the customer and Opencare, each Prime Appointment booked with a Prime Provider will be billed at the price set for the Prime Provider at the time that the appointment was requested.
- i.e. Any changes in price on the Prime Provider will affect all appointments requested AFTER the change was made, regardless of when the appointment is booked for.
- The credit card assigned to each provider will be billed on the 10th day of each month, and will include all Prime Appointments happened in the previous month.
- Each credit card will only be charged once, with the sum of all Prime Appointments for all Prime Providers with that card assigned.
- A receipt will be provided via email on a per-card basis with a summary of the charges.
- Invoices can be downloaded by the credit card holders through the Opencare platform.
- Opencare reserves the right to suspend service if an account balance is overdue.
A Prime Provider may request a billing exemption in the following scenarios:
- The patient had seen the Prime Provider before booking through Opencare,
- The patient is 17 years of age or younger,
- The patient only attends a free consultation with no return visit,
- The patient is on a government-funded social assistance program.
- In order to validate a billing exemption, we may ask for details about how the patient was contacted, details about the appointment booking, and may follow up with the patient directly to evaluate the reason for the billing exemption.
- Opencare retains the right to reverse billing exemptions for appointments that are later confirmed with patients and which meet all Prime Appointment Criteria.
- Refunds will be provided if Opencare has confirmed that a patient did not visit the clinic or scheduled an appointment within 30 days after a patient was billed.
- In order to validate a refund, we may ask for details about how the patient was contacted, details about the appointment booking, and may follow up with the patient directly to evaluate the reason for them not visiting the clinic.
- Refunds will be applied immediately once they are approved, and the customer will receive a receipt for the refund via email.