Office Policies & Procedures

Our office is open Monday – Friday from 8:30am – 5:00pm and can be reached by phone at 415-566-1000 from 9:00am – 3:00pm. We are closed for major holidays, including the week between Christmas and New Year.

Elation is the Electronic Medical Record (EMR) software utilized by our office. Elation Passport is the preferred method of contact for the office and may be used to directly contact your provider,  upload pertinent paperwork, request appointments, express health concerns, request prescription refills, and order supplements. Please note that an updated email address is required for Elation Passport enrollment.

SFPMG Care Tip: If you do not have internet access please call our office and we will make the necessary accommodations.

Non-urgent calls and messages will be returned within 48 business hours. Please call our office directly for any urgent, time-sensitive issues. For any and all emergencies and/or life-threatening issues, please call 911 or visit your nearest Emergency Room.

Your Initial Appointment:

In order for your appointment to be efficient and productive, please complete all new patient forms sent to you via Elation at least two (2) days prior to your first appointment. On the day of your appointment, please arrive at the clinic 15 minutes prior to your scheduled appointment time.

SFPMG Care Tip: We highly value collaborative care and advise that your Primary Care Physician be informed of our evaluation and treatment plans to ensure compatibility and safety of all prescribed medication.

During your initial appointment, your provider will review your medical intake forms, obtain a thorough medical and relevant personal history, and review previous lab work. They will then discuss and recommend treatment options and useful, pertinent follow-up testing. Please plan to spend up to two hours at this visit. 

SFPMG Care Tip: The quantity of information shared and discussed during a first appointment can be overwhelming. We recommend that you bring a trusted family member, partner, close friend, or medical advocate to your initial evaluation to help you process what is discussed and ensure your questions and concerns are thoroughly addressed.

Laboratory Testing: 

Our office utilizes a wide range of laboratory testing. Commercial testing, such as those performed by Quest or Labcorp may be covered by most insurances. Please make sure that your insurance information is presented when services are rendered. Specialty labs (i.e. Vibrant Wellness, InfectoLab, MyMyco Lab) are often out-of-network and may require prepayment.

Certain treatments for tick-borne illnesses require a Center for Disease Control (CDC) positive result.  It may be necessary to repeat specific lab testing prior to initiating treatment.

SFPMG Care Tip: For those without insurance or with limited network options (ie Kaiser), we utilize Labcorp Professional Co-op for discounted lab testing. Please speak to your provider to learn about these services.

Your Second Visit: 

Within your second visit you will review your most recent lab results and further develop your plan of care. Please plan to spend forty-five (45) minutes to one (1) hour for this visit. 

SFPMG Care Tip: Lab results may be difficult to accurately interpret without sufficient guidance from a medical professional. We recommend that the first review of your initial test results be with your provider.  However, if you would like to view your results prior to your second visit, please feel free to request a copy of your report.  Following this visit, specialty testing results will be sent to you through Elation Passport upon receipt.

Follow Up Visits: 

In general, follow-up visits are scheduled for thirty (30) minutes every 4-8 weeks.  The length and frequency of your follow-up appointments may vary due to case complexity and treatment requirements.

We do our best to estimate the time needed for your next visit. Please note that the length of time for each appointment is subject to change during your visit. All visits are scheduled in 15 minute increments.

Limited New Patient Visits:

Limited visits include referrals from another provider for a specific treatment and acute visits for urgent issues such as recent tick bites and active Covid infections. Limited visits will be shorter in length (15 – 30 minutes) and will include a shorter, modified intake of your medical history.  A follow up appointment with one of our providers may be required based on the nature of your treatment plan.

Please note limited visits are scheduled to address specific treatment needs. To have your provider assess and treat other healthcare needs, you may schedule an additional 1 hour consultation to fully establish with our practice.

California Non-residents:

Please note for non residents of the state of California, your first appointment will need to be scheduled in-person. Additionally, you will be required to complete an in-person visit once every 3 months to remain under the care of your provider. Phone and video consultations are available but are not meant to replace in-office follow up visits.

Please account for any and all travel requirements necessary to maintain your status as a patient.

We kindly ask that you request refills during your consultation with your provider. Should you need to have a prescription refilled in-between visits, please call your pharmacy and have them fax a refill authorization request form to our office: (415) 665-6732. Please allow 48 business hours for our staff to process this request. If you have already contacted your pharmacy and it has been 48 hours, please reach out to us through Elation Passport or via phone and we will address your refill needs promptly.

Your provider may prescribe supplements as part of your treatment plan.  For convenience, some of those supplements may be available for purchase in our office or shipped to the patient. Standard shipping (typically 2-7 days) is $20. Standard shipping fees will be waived for supplement purchases equal to or exceeding $200.  Overnight shipping is also available; fees vary according to shipping address, but begin at a rate of $50.

Please be aware that we have a no-return policy for supplements purchased in our office. Please contact your provider if you have any questions or concerns regarding a supplement you have purchased.

Supplements may also be prescribed and purchased through Fullscript, our online dispensary, or purchased through other online vendors (ie Researched Nutritionals, etc.).  Your provider will assist you with navigating where to find them.


Dr. Mischa Grieder, ND and his associates are fee-for-service, self-pay practitioners. We do not participate with any U.S. Federal Government Health Insurances, including Medicare/Medicaid or Tricare.  Most prescriptions and commercial labs (i.e. Quest, Labcorp) are covered by insurance; however, we cannot guarantee coverage on behalf of your insurance company.


If you desire to submit a superbill for potential, out-of-network insurance reimbursement, please notify our office at the time of service.   Please note that requests exceeding five (5) superbills may result in an administrative fee.

# of Superbills Fee Processing Time
1 – 5 $0 2 business days
6 – 10 $10 3 business days
11 – 20 $20 5 business days
21 – 30 $30 7 business days
31 – 40 $40 10 business days
41 + $50 10 business days

SFPMG Care Tip: If you are curious about potential reimbursements for consultations, lab work, and IV treatments, we encourage you to proactively contact your insurance representative to better understand and maximize your out-of-network benefits.


Payment is due at time of services rendered. We require that you keep a current and active credit card on file to use for charges associated with our office including office visits, treatments, testing, supplements, and cancellation/no-show fees. Please be prepared to supply your credit card number, expiration date and CVV or security code. In the event that you have a phone or video visit and we are unable to reach you for checkout, your card on file will be charged for fees associated with your visit.

SFPMG accepts the following forms of payment: cash, personal checks, MasterCard, Discover, Visa, American Express, Health Savings Account (HSA) and Flexible Spending Account (FSA) cards, and Care Credit. All checks should be made out to SFPMG. Please be aware that if your account happens to develop an outstanding balance, your treatment may be temporarily suspended until your open balance is paid in full.

SFPMG Care Tip: If you are experiencing financial hardship, we encourage you to proactively reach out to our Practice Manager to discuss a plan of action to continue care.Cancellation and No-Show PolicyOur priority is to provide the highest-quality patient care to all of our patients and to be fully prepared for your visit.

Our priority is to provide the highest-quality patient care to all of our patients and to be fully prepared for your visit.  We kindly ask that you provide sufficient notice if you are unable to make your appointment. If we are not notified, please be aware that there will be a cancellation fee associated.  All cancellations should be communicated via Elation Passport, a direct conversation with a member of the Front Desk Care Team, or by voicemail. Please note, tardiness exceeding twenty (20) minutes, may incur a cancellation fee and rescheduling of your appointment.

Cancellation fees will be waived for patients needing to cancel due to a positive Covid result. Positive test results should be provided to a member of the Front Desk Care Team.

New Patients

  • Standard New Patient Visits (90 min) require (5) five business days’ notice to cancel or reschedule your appointment. Doing so without the required notice will result in the forfeit of your deposit.
  • Limited New Patient Visits (30 min or less) require twenty-four (24) business hours notice to cancel or reschedule your appointment. Doing so without the required notice will result in the forfeit of your deposit.

Established patients

We require a minimum notice of forty-eight (48) business hours to cancel or reschedule your consultation appointment. Insufficient notice will incur the following fees:

  • 24 hrs or less: Full Price of scheduled consultation
  • 25-48 hrs: 50% of scheduled consultation

Infusions or procedures

  • Standard IV infusions canceled or rescheduled with less than 24 business hours notice will be charged a fee of $85.
  • Ketamine and Ozone IV procedures canceled or rescheduled with less than 48 business hours notice will be charged a fee of $300.

Please note that we have a strict cancellation policy in place for IVIG due to the extensive involvement of the nursing and administrative teams. This policy is necessary to ensure that we can continue to provide high-quality care to all of our patients. Appointments canceled or rescheduled without sufficient notice will incur a fee as outlined below:

Sufficient Notice: An IVIG appointment is canceled or rescheduled with 28 days or more notice.

  • If your IVIG appointment is canceled or rescheduled with 14 – 27 days notice, you will incur a cancellation/rescheduling fee of $300 (25% of the IVIG Base Price).
  • If your IVIG appointment is canceled or rescheduled with 7 – 13 days notice, you will incur a cancellation/rescheduling fee of $600 (50% of the IVIG Base Price).
  • If your IVIG appointment is canceled or rescheduled with less than 7 days notice, you will be charged $1200 (100% of the IVIG Base Price).

If you have any questions or concerns about our IVIG cancellation policy, please do not hesitate to contact us.