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 CareCredit, at the time of your visit.
Monthly payment options are available through CareCredit. You may finance your treatment with manageable monthly payments ranging from 6 to 60 months. You may use the payment calculator to find out your options.
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 +1(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.
Why are you out-of-network? Why don’t you accept my insurance?
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. Contracted, or in-network providers, are only allowed to perform procedures that your insurance company has determined are the preferred method of treating your injury.
The guidelines of your specific insurance policy may exclude coverage for certain procedures, even when your physician or surgeon has determined they are the best option to relieve your symptoms and provide a long-term, successful outcome. We believe your surgeon should decide the best treatment for your injury or symptoms, not your insurance company. The Stone Clinic has chosen not to contract with any insurance companies in order to have the freedom to perform the most technologically advanced orthopaedic surgery procedures available and provide an exceptional patient outcome and experience.
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.
For surgical services, we contract with a medical billing service that acts as a Patient Advocate by submitting surgical claims on your behalf and communicating with your insurance company to ensure you receive the highest possible reimbursement based on your out-of-network benefits.
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.
Are there monthly payment options?
Yes. You may finance your treatment with manageable monthly payments ranging from 6 to 60 months through CareCredit. You may use their payment calculator to review your financing options for treatment. (Note: Care Credit services are only available for U.S. residents).
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.