Office Policies

Appointments/Follow Up:

When you make an appointment, be sure to let our receptionist know the reason for the visit to properly allow for adequate time.

  1. Patients must make a follow up appointment with the provider to discuss any test results.  We do not give results over the phone.  YOU MUST make an appointment to discuss the results.  In the worst case scenario, if you do not hear from the provider about these results it is your responsibility to make an appointment with the provider to discuss results

  2. If you wish to discuss test results that were ordered by another provider or from another office, when you must make an appointment, let the office staff know so we can obtain the results or you can bring a copy of the test results with you to your appointment.

Appointment time:

Patients arriving more than 20 minutes late will be asked to reschedule or seen as a walk in patient if time allows.

Same day appointments:

We understand you or your family member is sick, so you worry.  You want to be seen right away to make sure it is not serious, you can come in as a walk in patient.  If it is a true emergency we ask that you go to the nearest emergency room.  We cannot guarantee or predict the wait time.

Missed appointment fee:

Patients, who fail to cancel with less than 24 hour notice, will incur a $50 fee.  This fee must be paid before a new appointment is scheduled.  Patients with three missed appointments will be asked to transfer to another provider.

Phone calls:

For truly life threatening emergencies call 911.

Our phones are generally busiest early in the morning when we first open and right when we return from lunch.  Our business hours are from 8:00am to 5:00pm. Monday thru Thursday and 8:00am to 12:00pm on Friday, closed on Saturday and Sunday.

If we are busy we do prioritize phone calls according to nature of the call, if you are asked to wait on hold please be patient.

Prescription refills:

All patients must return every two months for prescription refills or sooner as determined by your provider.  No refills will be issued to your pharmacy without a scheduled appointment.  You are expected to time your office visits with your prescriptions.

Please plan ahead so that you do not run out of important medications.  We cannot refill medications we did not prescribe or to patients that have never been seen in our office.  We will not prescribe or refill medication on weekends or holidays.

Controlled and Narcotic medications will require patients to be seen monthly for observation.

Form Fee

There is a $25.00 fee for all forms that we are required to complete including but not limited to, Disability, Gas & Electric Discounts, Insurance Physicals or DMV Forms, etc. There is a $20.00 fee for Disability extension forms.


Disrespect towards the staff, including but not limited to verbal abuse or physical violence or threats, will not be tolerated.  If this is not met we have the right to refuse service and/or discharge the patient from the practice.

Waiting Room and Examination Rooms:

Please no cell phone, food: drinks or pets allowed, except for service animals.

In the examination rooms we ask that only the patient with the appointment be in the room, except for caregivers for patient who require assistance.  If the patient is a minor, parents and guardians are welcome.


If you have a balance on your account, we will send you a statement.  It will show separately the previous balance, any new charges to the account, the finance charge, if any, and any payments or credits applied to your account.  We will only issue three statements for unpaid balances.  After that we will forward the balance to a collection agency and asses a $50.00 fee.


Unless other arrangements are approved by us in writing, the balance on your statement is due when the statement is issued, and is past due if not paid within 30 days.  If your balance is less than $50.00, we will accept a minimum of $10.00 per month.  If balance/payment has not been paid we have the right to refuse service.

Required Payments:

Any copayments required by an insurance company must be paid at the time of service.  Because this is an insurance requirement, we cannot bill you for these.  If you are unable to pay your co­payment at the time of service, we will ask you to reschedule for another time.


All deductible amounts are to be paid upon check in.  Any additional services rendered not covered by your insurance must be paid upon check out.

Payment Options:

If you do not have insurance, we accept payment by cash or credit card (Visa, MasterCard, Discover, PayPal Credit Card).  At this time we do not accept personal checks or American Express.  All payments must be paid at the time services are rendered.

Non-contracted Insurance:

Insurance is a contract between you and your insurance company.  We are not a party to this contract, in most cases.  We will bill your primary insurance company as a courtesy to you.  However, we will require you to pay our current cash rate at the time of check-in.  If your receive payment from your insurance company and the amount is greater than the rate you paid, the additional sum must be paid to us to provide the full payment we billed to your insurance company.  You agree to pay any portion of the charges not covered by your insurance.


In case of divorce or separation, the party responsible for the account prior to the divorce or separation remains responsible for the account.  After a divorce or separation, the parent authorizing treatment for the child will be the parent responsible for those subsequent charges.  If the divorce decree requires the other parent to pay all or part of the treatment costs, it is the authorizing parent's responsibility to collect from the other parent.

Finance Charge:

A finance charge will be imposed on each item of your account (30) days of the time the item was added to the account.  The Finance Charge will be computed at the rate of one and a half percent (1.5%) per month or an Annual Percentage Rate of eighteen (18%).  The finance charge on your account is computed by applying the periodic rate (1.5%) to the “overdue balance” of your account.  The "overdue balance" of your account is calculated by taking the balance owed thirty (30) days ago, and then subtracting any payment or credits applied to the account during that time.  The minimum Finance Charge is $.50.

Past-due Account:

If your account becomes past due, we will take necessary steps to collect this debt.  If we have to refer your account to a collection agency, you agree to pay all of the collection cost which is incurred.  If we have to refer collection of the balance to an attorney, you agree to pay all legal fees which we incur plus all court costs.  In case of suit, you agree the venue shall be in Stanislaus County, California.


If you should include your past due debt in your case, we have the right to discharge you from care. Unless the past due debt is reaffirmed and payment is made in full.

Returned checks:

If we accept payment via Personal Check, there is a $25 fee for any checks returned by your bank in addition to the check amount.  For checks written fraudulently or under a closed account we will assess $100.00 in addition to the check amount.

Transferring/Copying of Medical Records:

All records requests require a records release authorization signed by the patient or legal guardian.  If you request a copy of your records, you will be charged a copying fee of $0.35 per page.  If a records request comes from another provider or organization, we will provide one (1) copy to them at no charge as required by law.  All copies of records over 30 pages total will be provided in PDF file format on CD.  You authorize us to include all relevant information, including your payment history.  If you are requesting your records to be transferred from another doctor or organization to us, you authorize us to receive all relevant information, including your payment history.

Waiver of confidentiality:

You understand if your account is submitted to an attorney or collection agency, if we have to litigate in court, or if you're past due status is reported to a credit reporting agency, the fact that you received treatment at our office may become a matter of public record.

Workers Compensation:

We currently do not accept patients using Workers Compensation claims.  If you have any questions, please call our office.

Personal injury:

We do not bill third party claims.  These cases will be treated as self-pay and ask that payment be made at the time of service.

Referral request:

We are pleased to obtain the necessary authorization from your insurance company and refer you.  This can sometimes take several days to complete, as some insurance companies require 72 hours to the process the request.

Hospital Relief:

In an effort to relieve our local hospital of seeing patients on an emergency basis, we have made arrangements with Doctors Medical Center in Modesto to see Pathway Healthcare patients in the event of a medical emergency.

We ask you to use Doctors Medical Center as your source of ER care.  You understand that if your life is at risk, you will go to THE NEAREST MEDICAL FACILITY to seek immediate medical attention.