Thunder Pain and Wellness's Policies


Effective March 12, 2020

Because the safety of our patients and staff is our number one priority, we are asking that patients and guests refrain from entering our office if they have come into contact with anyone who has coronavirus or is experiencing the symptoms listed below.

  • Fever or chills

  • Cough

  • Shortness of breath or difficulty breathing

  • New fatigue

  • New muscle or body aches

  • New headache

  • New loss of taste or smell

  • Sore throat

  • Congestion or runny nose

  • Nausea or vomiting

  • Diarrhea

If you have any questions, please contact us at 775-336-1256.

We appreciate your cooperation in helping to keep everyone in our community as safe and healthy as possible.

Appointment And Cancellation Policy

At Thunder Pain Management, our goal is to provide quality care for all of our patients. We know you value your time, and we’ll do our best to stay on schedule. That said, we expect you’ll show us and your fellow patients the same courtesy by following our appointment policy.

Schedule or Cancel an Appointment

Please call: 775.336.1256

Cancellation, No-Show, and Late Fees

Our Cancellation/No-Show fees are $100 for a new patient visit, $60 for follow-up visits and therapy visits, and $200 for infusions. We’re happy to waive these fees if you call and cancel your appointments at least 48 hours in advance for office and therapy visits, and 72 hours in advance for infusions. Arriving more than 10 minutes late for a visit with Dr. Thunder or Pearla McDonald, APRN, will also be considered a no-show, in which case you will need to reschedule your appointment, and you will be charged a cancellation fee. If you’re unable to pay your required co-pay at the time of your appointment, you’ll need to be rescheduled, and that will count as a no-show as well.

Because physical therapy billing is based on time, patients who arrive even 10 minutes late for their appointments decrease our compensation by about 25%. When certain insurance companies barely pay enough for us to cover expenses, this becomes unmanageable. Therefore, we ask all our patients to partner with us to follow these guidelines:

  • If you are 10-15 minutes late for a therapy appointment, and you would like to go ahead with your appointment, you will be required to pay an extra $30 in addition to any copay to make up for the lost billing time.

  • If you are 10-15 minutes late and you choose not to go ahead with your treatment, you will be assessed the $60 cancellation fee.

  • If you are more than 15 minutes late, you will be considered a no show and charged the $60 cancellation fee.

  • Patients who are repeatedly late and/or have multiple cancellations/no shows without adequate notice may not be allowed to have additional therapy.

Fees are payable immediately, ineligible for insurance coverage, and solely the patient’s responsibility. If missing or being late to your appointment was due to unforeseen or unavoidable circumstances, we encourage you to appeal the fee by emailing officemanager@thunderpain.com and explaining your situation. If your request to have the fee waived is approved, the amount collected will be applied to any balance that you have on your account. If your account is paid in full, the fee will be refunded to you.

Reimbursement/Overpayment Refund Process and Information

While TPM makes all reasonable efforts to estimate the patient’s out of pocket or co-payment due at the time of service, occasionally overpayments may occur. If TPM becomes aware of an overpayment or mistake in payment (either through TPM’s discovery or notification by the patient), TPM will process this overpayment either back to the patient or to the insurance, whichever is indicated. Refunds are processed every thirty days. Please let us know if you have an urgency for reimbursement.

Refund per Written Request

If you believe an overpayment has occurred and you would like to request a refund in writing, please send a letter of explanation, including the patient’s name, date of birth, date of service, and request for overpayment refund to: Thunder Pain Management, 6548 S. McCarran Blvd., Suite A, Reno, NV 89509. Discovery of overpayments or questions regarding a balance may also be addressed by calling: 775.336.1256​​​​​​​

Credit Card On File

Thunder Pain Management does not send statements in the mail. We require a credit or debit card on file with our office.

Why Do You Use Credit Card On File?

There are several reasons. First, statements are wasteful of paper, stamps, and envelopes. Second, we need to ensure that we have a guarantee of payment on file in our office. Things are changing in healthcare, and we need to be sure that balances for which the patient is responsible are paid in a timely manner.

But I Always Pay My Bills, Why Me?

We have to be fair and apply the policy to all patients. We have wonderful patients, and we know that most of you pay your balances. Unfortunately, this is not the case every time.

How Will I Know How Much You Are Going To Charge Me?

You will receive a letter in the mail from your insurance carrier that explains how much of your office visit they pay and how much you pay. This is called an Explanation of Benefits (EOB.) This letter tells you exactly, according to your health insurance coverage, how much of your health care bill is your responsibility and how much is the responsibility of your insurance to pay.

Then What?

We receive the same letter you do. It arrives about 20 – 30 days after your appointment. We look at each Explanation of Benefits (EOB) carefully, and see what your insurance has determined as patient responsibility. This is the same way we normally determine how much to send you a bill for in the mail.

But Wait, I’m Nervous About Leaving You My Credit Card.

We do not store your sensitive credit card information in our office. We store it on a secure website called a gateway. We access your information on this site only to process a payment.

Unlike some retail stores that have been featured in the news recently for data breaches due to skimping on protective technology, we follow the Payment Card Industry Data Security Standards to the letter and will not compromise your data security. Medical practices are used to having to secure information under HIPAA laws, and we already have policies in place for any credit card information we come into contact with.

Keeping the patient’s card on file, offsite, in an encrypted payment gateway enhances security because there are fewer human touches in the process that can invite fraud. If patients swipe their cards at every checkout for time of service payments, then their card data is exposed at every visit. If the card is handed to an employee to swipe, the card is exposed magnetically and it is exposed to another human being. With a credit card on file system, after the initial swipe, the patient doesn’t even have to bring the credit card to the visit, or enter the PIN during the visit.

What If I Need To Dispute My Bill?

We will always work with you to understand if there has been a mistake, and we will refund you if we have made a billing error. We will only charge the amount that we are instructed to by your insurance carrier in the same way that we normally determine how much to send you a bill for in the mail.

What Is A Deductible And How Does It Affect Me?

An annual deductible is the dollar amount you must pay out of pocket during the year for medical expenses before your insurance coverage begins to pay.

For example, if the policy has a $500 deductible, you must pay the first $500 of medical expenses before the insurance company begins to pay for any services.

This works just like the deductible for your car insurance or homeowner’s insurance policy does.

When Does A Deductible Begin?

Your deductible begins at the start of your plan year. Most plan years begin either January 1 or July 1, but plans can start on any date.

When Do I Have To Pay For Services?

Any time you receive medical care, you will be expected to pay in full for your services until your deductible is met. If you have a very large deductible, called a high-deductible insurance plan, you may have to pay out of pocket for most of your primary care services.

How Will I Know When My Deductible Has Been Met?

You can call your insurance company at any time to check on how much of your deductible has been met and some insurance companies have this information available online. Every time you receive medical services, you will receive notification from your insurance company with how much they paid or did not pay if the amount went to your deductible.

Will You Send Me A Bill To Let Me Know What I Owe?

Thunder Pain Management will not send patient statements, which wastes paper, stamps, and envelopes. All patients are required to keep a credit or debit card on file, but we do not charge anything to your card except the balances that are your responsibility.

What If I Have More Questions?

Our staff is happy to speak with you about your account at any time.​​​​​​​


We are preferred providers on many commercial medical plans. It is, however, each patient’s responsibility to contact their insurance company to make sure our providers are covered under an individual plan. This includes: Thunder Pain Management, Dr. Kenneth Thunder, and Pearla McDonald.

We are Medicare providers. We do not take Medicaid at this time.

Automobile Accidents, Worker’s Compensation, Personal Injury, and Disability

Dr. Thunder and the staff at Thunder Pain Management are committed to helping as many people as possible. Because we’re a small office with limited resources, we’re unable to manage the vast amounts of time and paperwork associated with automobile accidents, worker’s compensation, personal injury, or disability. If you currently have an open claim, we regret to inform you that unless we are considered preferred providers under your worker’s compensation plan, we’ll be unable to take you as a patient at this time. Please check back with us when your situation has changed.

Children Under 18

Children under the age of 18 years old must be accompanied by a parent/guardian while being treated at Thunder Pain Management. If a parent/guardian is absolutely unable to accompany the child, then another authorized and responsible adult must accompany them. The parent/guardian must complete a Permission to Accompany a Minor Form and give it to the front desk. We will need to see an ID from the accompanying individual at every visit. Additionally, the parent must also agree to be contacted by phone during the exam by the provider.

Privacy Policies And Practices

You may view, download, or print our HIPAA Omnibus Notice of Privacy Practices here.

Who we are

Our website address is: https://www.thunderpain.com.

What personal data we collect and why we collect it

When visitors leave comments on the site, we collect the data shown in the comments form and also the visitor’s IP address and browser user agent string to help spam detection.

An anonymized string created from your email address (also called a hash) may be provided to the Gravatar service to see if you are using it. The Gravatar service privacy policy is available here: https://automattic.com/privacy/. After approval of your comment, your profile picture is visible to the public in the context of your comment.


If you upload images to the website, you should avoid uploading images with embedded location data (EXIF GPS) included. Visitors to the website can download and extract any location data from images on the website.


If you leave a comment on our site you may opt-in to saving your name, email address and website in cookies. These are for your convenience so that you do not have to fill in your details again when you leave another comment. These cookies will last for one year.

If you have an account and you log in to this site, we will set a temporary cookie to determine if your browser accepts cookies. This cookie contains no personal data and is discarded when you close your browser.

When you log in, we will also set up several cookies to save your login information and your screen display choices. Login cookies last for two days, and screen options cookies last for a year. If you select “Remember Me”, your login will persist for two weeks. If you log out of your account, the login cookies will be removed.

If you edit or publish an article, an additional cookie will be saved in your browser. This cookie includes no personal data and simply indicates the post ID of the article you just edited. It expires after 1 day.

Embedded content from other websites

Articles on this site may include embedded content (e.g. videos, images, articles, etc.). Embedded content from other websites behaves in the exact same way as if the visitor has visited the other website.

These websites may collect data about you, use cookies, embed additional third-party tracking, and monitor your interaction with that embedded content, including tracking your interaction with the embedded content if you have an account and are logged in to that website.

How long we retain your data

If you leave a comment, the comment and its metadata are retained indefinitely. This is so we can recognize and approve any follow-up comments automatically instead of holding them in a moderation queue.

What rights you have over your data

If you have left comments on this site, you can request to receive an exported file of the personal data we hold about you, including any data you have provided to us. You can also request that we erase any personal data we hold about you. This does not include any data we are obliged to keep for administrative, legal, or security purposes.

Where we send your data

Visitor comments may be checked through an automated spam detection service.

Contact us

Please contact our office if you have additional questions.


Dr. Thunder is committed to helping his patients improve by using an integrative, whole-body approach to pain management. As a result of his experience and his in-depth research of chronic pain issues, he believes that the use of many medications that are currently prescribed for pain actually do more harm than good over the long-term.

Dr. Thunder understands that many patients are frightened by the idea of dealing with their chronic pain without the use of certain medications, such as opioids. Dr. Thunder’s goal is to work with his patients to improve their quality of life and as such is not a believer in the shock-and-awe approach of drastically decreasing prescriptions.

However, Dr. Thunder has found that opioids actually perpetuate and worsen chronic pain by causing increased sensitivity of the nervous system. As such, he is committed to helping his patients gradually taper down the amount of opioids they take, with the goal of eventually stopping them entirely.

There are some medications that Dr. Thunder does not prescribe because he believes they are dangerous or counter-productive to the patient’s long-term wellbeing. These medications include:

  • Soma (carisoprodol)
  • Benzodiazepines, such as, but not limited to:
    • Valium (diazepam)
    • Xanax (alprazolam)
    • Ativan (lorazepam)

If these medications are being used for muscle relaxation, anxiety, or insomnia, there are multiple alternative medications and therapies which are superior. Dr. Thunder will be happy to discuss them with you during your initial visit.