Frequently Asked Financial Policy Questions
Does The Stone Clinic accept my insurance plan?
Payment is required at the time of service and most insurance companies reimburse patients for our services as an out-of-network provider. Patients are given a “superbill” receipt when leaving our office, which can be sent immediately to their insurance for reimbursement. We do everything possible to assist patients in billing their insurance company. Payment plans are available.
Does The Stone Clinic accept Medicare?
Medicare patients should be aware that we have chosen to "opt out" of the Medicare program. What this means is that patients give up all Medicare coverage for services furnished by Kevin R. Stone, MD, and The Stone Clinic. Patients cannot bill Medicare or ask us to bill Medicare for any charges from our office. Medigap and other supplemental insurers may not pay either. However, please note that if surgical treatment is required, the surgery center and anesthesiologist will bill Medicare and any secondary insurance; these fees are typically paid by Medicare and supplemental insurance companies.
I've never billed my insurance company directly before. How do I do this?
Our "Insurance Billing Tips" form outlines several excellent suggestions to ensure your insurance reimbursement reaches your mailbox quickly. Please click here for our tips.
What if my insurance company denies my claim?
Fax a copy of your Explanation of Benefits (EOB) to the attention of our billing manager at 415-563-3301. We will be happy to review the EOB to see if there is anything she can do to aid you in receiving additional reimbursement.
I have Kaiser. Will they reimburse me for your services?
Kaiser and other HMO-type insurance companies have reimbursed patients for our services in the past. Your HMO's “Primary Care Physician” typically needs to refer you to an orthopaedic specialist within their network. If that specialist does not feel as though there is anything that can be done for your particular situation, many times they will authorize an “out-of-network” referral so you can benefit from Dr. Stone's unique procedures.
Should I send in my receipts after each date of service or should I wait until the end of my treatment?
The sooner you get your receipts to your insurance company, the sooner you will get reimbursed. Definitely be sure to keep a copy of everything you send them! Or, if you prefer to wait until the end of your treatment, we can print out one form for you to submit with all dates of service on one sheet.
I need new health insurance. Which insurance company do you recommend?
Please call our office at 415-563-3110 and our billing manager will go over your options with you and make suggestions. It is best to find a company that pays well for out-of-network providers and without a large deductible.
What is the difference between an in-network provider and an out-of-network provider?
An in-network provider is one contracted with a health insurance company to provide services to plan members for specific pre-negotiated rates. An out-of-network provider is not contracted with the health insurance plan. We chose to become an out-of-network provider for all insurance companies to ensure our patients receive the best care possible.
Does The Stone Clinic accept my insurance plan?
Payment is required at the time of service and most insurance companies reimburse patients for our services as an out-of-network provider. Patients are given a “superbill” receipt when leaving our office, which can be sent immediately to their insurance for reimbursement. We do everything possible to assist patients in billing their insurance company. Payment plans are available.
Does The Stone Clinic accept Medicare?
Medicare patients should be aware that we have chosen to "opt out" of the Medicare program. What this means is that patients give up all Medicare coverage for services furnished by Kevin R. Stone, MD, and The Stone Clinic. Patients cannot bill Medicare or ask us to bill Medicare for any charges from our office. Medigap and other supplemental insurers may not pay either. However, please note that if surgical treatment is required, the surgery center and anesthesiologist will bill Medicare and any secondary insurance; these fees are typically paid by Medicare and supplemental insurance companies.
I've never billed my insurance company directly before. How do I do this?
Our "Insurance Billing Tips" form outlines several excellent suggestions to ensure your insurance reimbursement reaches your mailbox quickly. Please click here for our tips.
What if my insurance company denies my claim?
Fax a copy of your Explanation of Benefits (EOB) to the attention of our billing manager at 415-563-3301. We will be happy to review the EOB to see if there is anything she can do to aid you in receiving additional reimbursement.
I have Kaiser. Will they reimburse me for your services?
Kaiser and other HMO-type insurance companies have reimbursed patients for our services in the past. Your HMO's “Primary Care Physician” typically needs to refer you to an orthopaedic specialist within their network. If that specialist does not feel as though there is anything that can be done for your particular situation, many times they will authorize an “out-of-network” referral so you can benefit from Dr. Stone's unique procedures.
Should I send in my receipts after each date of service or should I wait until the end of my treatment?
The sooner you get your receipts to your insurance company, the sooner you will get reimbursed. Definitely be sure to keep a copy of everything you send them! Or, if you prefer to wait until the end of your treatment, we can print out one form for you to submit with all dates of service on one sheet.
I need new health insurance. Which insurance company do you recommend?
Please call our office at 415-563-3110 and our billing manager will go over your options with you and make suggestions. It is best to find a company that pays well for out-of-network providers and without a large deductible.
What is the difference between an in-network provider and an out-of-network provider?
An in-network provider is one contracted with a health insurance company to provide services to plan members for specific pre-negotiated rates. An out-of-network provider is not contracted with the health insurance plan. We chose to become an out-of-network provider for all insurance companies to ensure our patients receive the best care possible.
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The Stone Clinic
Building Better Joints Through Advanced Techniques in Cartilage Replacement, Regeneration and Repair
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