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Financial considerations

In order to best serve the needs of our patients, The Stone Clinic is an out-of-network, fee-for-service provider.

We accept all major forms of payment, including Bitcoin & Care Credit, at the time of your visit. 

After your initial examination and before treatment, we suggest all patients contact their insurance carriers directly to obtain coverage information. Covered procedures will vary with each insurance company.

For your convenience, you will be given an itemized receipt when leaving the office, which you send directly to your insurance company for reimbursement. If you prefer, your surgical bills can be submitted to your insurance carrier by a third party billing service at no extra charge.  

We have opted-out of Medicare, which means our services are not covered by any type of Medicare or Medicare supplemental insurance policies. However, Medicare and Medicare supplement policies often cover the facility and anesthesiology charges associated with surgery.

Please contact our office at (415) 563-3110, if you have any questions. We are always happy to help patients figure out the best financial option. 

Frequently asked billing questions

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 that we can offer our patients the best care possible.

Do you accept my insurance plan?

The Stone Clinic is an out-of-network provider, which means we are not contracted with any insurance companies and, therefore, do not bill insurance for our services. Our patients make payment-in-full for our services at the time they are received, then submit their own claims directly to their insurance companies for reimbursement. At the end of your consultation, we will provide you with an itemized receipt, which can be submitted to your insurance company for reimbursement.

If you have out-of-network coverage, you will be reimbursed directly by your insurance company according to your plan’s specific out-of-network benefits. To inquire about your specific insurance coverage, you may call the Customer Service phone number listed on your insurance card for a detailed explanation of your policy.

Does The Stone Clinic accept Medicare?

We have chosen to "opt out" of the Medicare program. What this means is that you give up all Medicare coverage for services furnished by Kevin R. Stone, MD, and The Stone Clinic. You 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?

At the end of your consultation, we will provide you with an itemized receipt, which can be submitted to your insurance company for reimbursement. The claims mailing address can be found on your insurance card. For additional information regarding claims submission requirements specific to your insurance policy, please call the Customer Service phone number listed on your insurance card.

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. She will be happy to review the EOB to see if there is anything she can do to aid you in receiving additional reimbursement.

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. Be sure to keep a copy of everything you submit. 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.

Tips for billing your insurance company

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Kevin R. Stone · Jonathan R. Pelsis · Scott T. Surrette · Ann W. Walgenbach · Thomas J. Turek 

Platelet-Rich Plasma (PRP) is blood plasma that has been enriched with platelets.

Stone, K.R., A.W. Walgenbach, T.J. Turek, A. Freyer, and M.D. Hill. 2006.