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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 care credit, at the time of your visit. Payment plans are available. Patients with an out-of-network health insurance policy are typically able to get reimbursed for our services.
After your initial examination and before treatment, our office staff can assist you in determining insurance reimbursement. Covered procedures will vary with each insurance company.
For your convenience, you will be given a “super bill” 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, however Medicare and supplemental insurance companies typically pay the separate fees for the surgery center and anesthesiologist.
Please ask to speak to our billing manager, Jamie, 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?
Payment is required at the time of service and most insurance companies reimburse you for our services as an out-of-network provider. You are given a “superbill” receipt when leaving our office, which can be sent immediately to your insurance for reimbursement. We do everything possible to assist you in billing your insurance company. Payment plans are available.
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?
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. She 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 orthopedic 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. 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.
I need new health insurance. Which insurance company do you recommend?
Look for a company that pays well for out-of-network providers and has a plan without a large deductible. Our “How to Choose a New Insurance Plan” offers your further tips. We can talk through any questions you may have on the phone. Contact us