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Q: I have a billing question? 

A: Ask Rick!

Q: Who is this Rick you speak of?

A: Rick Acuna is The Stone Clinic's financial advisor and your number one advocate for any billing or insurance-related questions.  He has over 20 years of experience working with medical insurance companies and a 90% approval rate when submitting an appeal for patients of The Stone Clinic.  Rick is ALWAYS on your side.

Q: Does The Stone Clinic accept my insurance plan?

A: Payment is required at the time of service. However, most insurance companies do cover Stone Clinic services as an out-of-network provider. We will do everything possible to assist you in obtaining reimbursement from your insurance company. We provide you with a "superbill" receipt when you leave The Stone Clinic, which can be sent to your insurance company for reimbursement to you.  Be sure to put your date of birth and policy number on the form before sending it to your insurance.

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, M.D. 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. Please check with your insurance company if you have any questions regarding this policy. Patients pay at the time of service. Payment plans are available. Please note that if surgery is recommended during your office visit, the surgery center and anesthesiologist will bill Medicare and your secondary insurance.  Their fees typically are paid by Medicare and supplemental insurance companies.

Q: I've never billed my insurance company directly before.  How do I do this?

A: The attached "Insurance Billing Tips" handout outlines several excellent suggestions to ensure that your insurance reimbursement reaches your mailbox quickly.

Q: What if my insurance company denies my claim?

A: Fax a copy of your Explanation of Benefits (EOB) to Rick's attention at 415-563-3301.  Rick will be happy to review the EOB to see if there is anything he can do to aid you in receiving additional reimbursement.

Q:  I have Kaiser.  Will they reimburse me for your services?

A: Kaiser and other HMO-type insurance companies have reimbursed patients for our services.  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.

Q:  Should I send in my receipts after each date of service or should I wait until the end of my treatment?

A: 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.

Q:  I need new health insurance.  Which insurance company do you recommend?

A: Please call Rick at 415-563-3110 and he will go over your options with you and make suggestions.  Best to find one that pays well for out-of-network providers and without a large deductible.

Q:  What is the difference between an in-network provider and an out-of-network provider?

A: 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.

 

We can help. Simply: ask Rick!

 

For additional information, Rick can be reached at 415-563-3110 or rick@stoneclinic.com