New Patient Paperwork
Please ensure both linked forms above are completed and returned a week prior to your appointment. If unable, arrive at least 30 minutes early with your filled forms, or an hour early if you require assistance with completion, ensuring timely input before seeing your provider.
Patient Portal
FollowMyHealth is the patient portal for Shingletown Medical Center and allows you to check your personal records anytime from any device. Sign up for free.
You can register to manage your entire family’s medical information from FollowMyHealth
You can email with your provider through the patient portal
You have 24/7 convenience at home access to Shingletown Medical Center
You can receive your lab results on your portal
See the front office staff for information on registering for this important service.
General Questions
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The sound you hear after the message is actually from the phone system transferring your call to the answering service. It’s not hanging up on you, so please stay on the line!
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Think of your annual visit the way you think of taking your car in for service or cleaning the lint out of your dryer. You want to catch problems early and in some cases, prevent them from happening at all. Regular visits are especially important for children, because they grow so fast and have so many changes as they move toward adolescence.
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Scheduling lab appointment helps avoid a big crowd all waiting to get in at the same time. It also allows the MA time to properly prepare or process the labs before we send them to Quest – if this work is not done correctly it may mean inaccurate lab results.
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No, we are a full service primary care clinic and provide care to all ages. We do try to keep some appointments available every day for people who need an urgent care type visit; they are first-come, first-served.
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Medication refills involve multiple steps and there are multiple requirements. You may need lab work or a visit to ensure it’s still safe for you to take a medication or to determine if it’s working. If a medication is not on your insurance formulary, we have to try for a prior authorization, which may take as long as a week. Pharmacies, like most health-care organizations including SMC, are currently faced with high demand and struggling with staffing. You can help by letting us know at least three days in advance that you need a refill. Waiting until you have one or two pills left makes a hard job even harder.
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No; we can order it for you at your preferred pharmacy.
Billing Questions
Our Billing office is available by appointment only for any coverage or payment related questions. For help regarding government programs or signing up for medical insurance, please contact the Emergency Food Closet and Resource Center.
(530) 474-1399
31191 Unit A Highway 44
Shingletown, CA 96088
By Appointment Only
M, W, F: 7am - 12pm
Tu, Th: 9:30am - 5pm
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Most insurance plans require you to pay a deductible and/or co-insurance. In addition, you could be responsible for non-covered services. Please contact your insurance company for specific answers to your questions. You may have out-of-pocket expenses.
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Be sure SMC has the information for both of your insurances. You could be responsible for non-covered services. Please contact your insurance company for specific answers to your questions. You may have out-of-pocket expenses.
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Call the number listed on your bill.
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We accept Medi-Cal, Medicare, CMSP, Partnership Health Plan and many private insurances. If your coverage requires you to have an assigned primary care provider, please ensure you are assigned to SMC. Please remember to bring your insurance ID card and any co-payments to every appointment.
Insurance & Eligibility
Our staff helps patients and potential patients understand health insurance and eligibility requirements in order to obtain health insurance. We make sure patients understand how to obtain, as well as access, healthcare. We can help new patients enroll in insurance, re-enroll patients with existing insurance, and review options for any other programs patients might qualify for. We accept Medi-Cal, Medicare, Covered California and all Major/Minor Insurances.
Assist in determining insurance eligibility for programs such as:
Medi-Cal
Medicare
Covered California
How Does Eligibility And Enrollment Work?
Eligibility and enrollment services are now available and affordable to patients.
We accepts most insurance plans, but if you or someone in your household is uninsured or underinsured, we can help screen you for eligibility and apply to receive public benefits for which you may be eligible.
If you don’t qualify for insurance, we offer a Sliding Fee Scale for self-pay patients based on family size and income. Shingletown Medical Center will never refuse care to anyone based on their ability to pay.
Do You Need Health Insurance?
To find out if you or someone in your household is eligible for California public benefits, you can apply online for Covered California. You may also call one of our trained certified enrollment counselors by calling (530) 474-3390.
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are self-pay, an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, and equipment. The information provided is only an estimate regarding items or services reasonably expected to be furnished at the time the estimate is issued and that actual items, services, or charges may differ from the good faith estimate.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
This is an estimate, and your actual charges may differ. If you receive a bill that is $400 or more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
For questions or information about your right to a Good Faith Estimate, visit Centers for Medicare & Medicaid Services or call the Shingletown Medical Center billing office at (530) 474-1399.
Advance Health Care Directives
An Advance Health Care Directive lets you name someone to make treatment decisions for you. That person can make most medical decisions-not just those about life-sustaining treatment-when you can’t speak for yourself. Besides naming an agent, you can also use the form to say when you would and wouldn’t want particular kinds of treatment.
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Generally, you do, although there are some exceptions spelled out in laws and regulations. You have the right to agree to treatments you want to receive and to refuse treatments you don’t want to receive.
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Your doctor must inform you about your medical condition and about what different treatments can do for you. Your doctor must also tell you about serious problems that medical treatment is likely to cause you.
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You can use an Advance Health Care Directive to name someone to make treatment decisions for you when you can’t. You can also use the Advance Health Care Directive to write down your wishes about medical treatment ahead of time. That way the person you have named will know what you want.
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An adult who you trust to make decisions for you as your agent.
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If you can’t make the decisions yourself, someone will have to make the decisions for you. If you haven’t named someone to make the decisions when you can’t, then it may fall to your family or the doctor to make the decisions. By writing down your wishes about medical treatment ahead of time, you can let them know what you want, even if you haven’t named someone to decide for you.
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Ask your care coordinator or your doctor to get more information for you.
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It is your responsibility to give your healthcare providers a copy. Be sure to keep one for yourself.
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No, it is completely voluntary.
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You can change or revoke what you wrote or told the doctor just by telling the doctor that you have changed your mind.
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You don’t have to use the form, but using a form that meets the legal requirements for an Advance Health Care Directive will make it easier for doctors to follow your wishes if someone, such as a relative, disagrees with what you wrote down. If you don’t use the form, you can write down your wishes about your medical treatment on a piece of paper. In fact, you can tell the doctor what you want and ask the doctor to write it down. Again, using the form makes it more likely that your wishes will be followed.
Requesting Medical Records
Records are released in accordance with state and federal laws. To receive copies of your or your children’s records you must first sign a release of information giving us permission to release the records. You have the right to request records for your dependent children if they have not yet reached the age of 18. Once 18, a person must sign for their own records.
The following people are authorized to sign for release of your health information:
The patient (Not the spouse)
Power of attorney if the patient is unable to sign (Legal document must be provided.)
Parent (if the patient is younger than age 18)
Legal guardian (Proof of guardianship document must be provided.)
Representative of the estate for deceased patients (Copy of the death certificate and a copy of the representative of estate documents must be provided.)
By subpeona
Copies are processed within 15 to 30 days from the date the request is received. Recipients will be notified if the request cannot be processed within that time frame.
If you have any questions, please contact the records custodian.
Emergency & After Hours Procedures
In any emergency, dial 911
With all the planning possible, it is very likely that at some point, you or a family member will get sick or injured when the clinic is closed. It is good to be prepared before that happens. Shingletown Medical Center has a 24-hour a day nurse triage service to handle those situations.
Should you need to speak with a medical provider please call SMC’s main line at (530) 474-3390. You will receive triage for your medical problem and if necessary they will contact their provider who will take care of you. The triage service sends SMC a daily report of all after-hours calls so we can follow up with you.
