Maximizing 2021 insurance benefits
We’re past the half-year mark— it’s a great time to remind your patients about potentially using their 2021 insurance benefits to upgrade their Cochlear sound processor. Our newest technologies, the Cochlear™ Nucleus® 7, Kanso® 2 and the Baha® 6 Max Sound Processors are designed with your patients’ needs in mind.
Encourage your patients and their caregivers to plan ahead. The insurance approval process can take 6-8 weeks and benefit qualification by the patient’s insurance company is dependent on when the order is shipped from Cochlear, not when the order is placed. Insurance companies require replacement order claim submissions in 2021 to ship by the end of the year, and the last day that Cochlear will be shipping orders is December 30, 2021. We recommend placing replacement sound processor orders no later than October 29, 2021. †
Cochlear is here to help
Reimbursement and Insurance Services at Cochlear helps your patients through the insurance reimbursement process. Our Insurance Support Center provides helpful resources for your patients. We will work with you to determine medical necessity and collect all documentation needed to bill your patient’s insurance directly for their sound processor upgrade.1
Parts and accessories
Did you know Cochlear provides direct insurance billing for covered parts and accessories, such as rechargeable batteries, coils and cables, for many contracted private insurance plans as well as Medicare, many state Medicaid plans (including HMOs), and TRICARE?2, ‡
Patients have the option to shop in insurance mode, where they will see only parts and accessories that are generally covered by insurance, on the online Cochlear Store. In insurance mode, they can place orders and bill them directly to their insurance if they are covered by a plan that is contracted with Cochlear.3
†Orders placed on or before October 29, 2021 are not guaranteed to be approved by an insurer or shipped on or before December 30, 2021, the last available shipping date to meet the insurance deadline. Placing an order through Cochlear’s Reimbursement and Insurance Services does not imply approval from an insurance carrier.
Information for patients:
1. Information provided by Cochlear Americas regarding insurance coverage or reimbursement is provided as guidance only and is not intended as reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding such information or its completeness, accuracy, fitness for a particular purpose, or that following such guidance will result in any form of coverage or reimbursement from any insurer. Information presented is subject to change at any time. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own experts and seek your own legal advice regarding your reimbursement needs. In all cases, products or services billed must be medically necessary, actually performed and appropriately documented in the medical record. You will be responsible for paying any applicable coinsurance, deductible, or amounts not covered by your insurance to Cochlear. Coverage determinations and out-of-pocket costs may vary for individuals with private insurance.
2. As of Feb 1, 2018, Cochlear provides direct insurance billing support for many major private insurance plans, Medicare, Medicaid‡ (including HMOs) and Tricare for repairs, parts and accessories. Cochlear’s full-service billing support is available for recipients who are covered under one of the plans with whom Cochlear is contracted. If you would like to place an order for a replacement part or accessory, please keep in mind orders may take up to 2 weeks to process and ship, so please plan ahead.
‡Cochlear is currently enrolled with Medicaid programs in the following states: AZ, CA, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, and WY.
3. Please keep in mind, if you choose to self-pay today, you may not be able to submit a claim to your insurance on your own if Cochlear is contracted with your private insurance provider. Visit http://www.Cochlear.com/US/insurancelist to see if Cochlear is contracted with your insurance provider. If Cochlear is contracted with your insurance provider, we suggest placing your order through Cochlear’s Reimbursement and Insurance Services.