by Cochlear Guest Author

Action needed: Medicare 2021 proposed rule

September 21, 2020

The Centers for Medicare and Medicaid Services (CMS) released the 2021 Medicare Physician Fee Schedule (MPFS) proposed rule on August 3, 2020. The proposed rule will implement a budget neutrality requirement for all procedure codes paid under the MPFS, which will impact multiple specialty healthcare providers.

CMS also proposed a decrease in the 2021 conversion factor from $36.09 to $32.26. The conversion factor is a multiplier used to convert the geographically adjusted Relative Value Units (RVU)s for each code to determine the Medicare allowed amount for covered procedures.

As a result of the proposals, audiology services will see a 7% reduction in the allowable rates of their covered services.

For additional information on the proposed rule and its impact on audiology and SLP services, please visit ASHA’s website.

All comments are due to CMS October 5, 2020.

Author

Cochlear Guest Author

In an effort to keep our content fresh and reflective of a diverse industry, Cochlear Americas features a mix of employees and professional partners to contribute to Cochlear ProNews as Guest Authors.

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Why telehealth matters: Remote Check

April 19, 2021

By Julie Purdy, Ph.D., CCC-A and Keri Colio, Au.D., CCC-A

Background

When we work with children with cochlear implants, we are aware of the many appointments that families must juggle. While this is a strain on all of our families, for some it is even a greater challenge if their children are medically fragile or live long distances from the center or satellite centers. COVID-19 has shined a light on the need for audiologists to move beyond sound booth service delivery. There are few tele-audiology models and most require an audiologist to use a camera or video system to connect to a facility closer to the child’s rural location. We were fortunate to be part of the pre-market release of Remote Check, which allowed us to pilot this new technology. Remote Check allows patients to complete a series of hearing tests from the comfort of their own home from their compatible device using the Nucleus® Smart App.*

Results

We received access to Remote Check in June of 2020. We then contacted all eligible Cochlear Nucleus 7 recipients and asked if they would like to participate in a Remote Check pilot with our center. Once a family expressed interest, they were enrolled and guided through this process:

First, the Remote Check feature of the Nucleus Smart App was activated.
Then, we unlocked the activities that we wished for each applicant to use by choosing from the following: impedance check, implant site photos, audiogram, speech in noise test, datalogging and questionnaires.
Once the child and family had completed Remote Check, the results were sent directly to us to review within myCochlear.
Based on the results, we determined if the family needed an appointment which could consist of a tele-audiology appointment, remote tablet programming or in-person services. For the majority of our families, a tele-audiology appointment was sufficient.

We quickly became fans of this technology and made decisions on how we wanted to integrate this wonderful technology into our existing clinical services.

Lessons learned

Don’t send all activities to all families – be specific based on the information to be obtained. For example, there’s no need to send the speech in noise test to a young child!
Look at the questions that the software flags for review. These questions and answers will direct you towards determining the appropriate follow-up.
Be sure to check progress, or lack thereof, if Remote Check has been completed before. Previous results are available to view on the audiogram, speech in noise testing and questionnaires all within myCochlear Remote Check review.
Our clinic schedules a tele-audiology appointment to review the test results. Parents are interested and will have questions.

Case examples

Several families, mainly parents of young children, have requested Remote Check due to head injury and concern regarding the internal device. The ability to measure impedances remotely has saved many families a 2+ hour trip to the clinic to complete a test that takes less than 10 seconds. The families have been extremely grateful to have access to this type of remote care.

Remote Check has also been a crucial tool for our families who have been unable to return to the clinic, or the United States, during the COVID-19 pandemic. We have several families who are unable to cross the Mexico-US border and who are currently living with relatives in other countries. These families have been thankful for the opportunity to test their devices remotely and review the results with their audiologists via telehealth methods.

Conclusion

While many professions have been able to move quickly into providing telehealth, audiological efforts have, on the whole, stalled at institutions around the country. Remote Check is a valuable battery of activities which can effectively be used with our remote/fragile patients to better monitor the functioning of their devices and success of use.

Baha® Fitting Software 6.1 – Quality care, anywhere

May 10, 2023

By Wendy Potts, Product Manager for Software & Connected Care at Cochlear Americas

Cochlear^™ Remote Care is now available in Baha® Fitting Software 6.1.

We understand you want your patients to receive ongoing and consistent care. However, for some patients, access to care may be limited by geography, mobility, or family and work responsibilities. Other patients may be progressing well, but you would still like to monitor them and provide timely care when they need it. And sometimes patients simply want a quick solution to a problem or the convenience of upgrading to a new processor at home.

Cochlear^™ Remote Assist^* for Baha® 6 Max Sound Processors allows patients to meet with you remotely via a video appointment, where you can assess and support your patient’s hearing progress without the need for them to visit the clinic.

Patients can conveniently access remote care through Remote Assist on their compatible smartphone^{^} at home, at work, or when they’re away.

You can provide care remotely to your adult and pediatric patients in the Baha Fitting Software through a live video, audio, or chat session and can connect to the sound processor for programming. Once connected, you can complete a full fitting (including BC Direct and Feedback Analyzer), make programming adjustments, enable processor settings and programs, and provide counseling. Any programming changes are saved remotely to the patient’s sound processor.

Baha Fitting Software (BFS) 6.1 features include:

Remote Assist

With Remote Assist, you can offer your patients the convenience of quality hearing care without the need to visit the clinic. You have the flexibility to manage patient progress remotely and the ability to offer care to more patients, including those who may be limited by location, health, mobility, or work commitments.

Figure 1: Remote Assist Feature in Baha Fitting Software 6.1

Remote Assist for Baha allows access to all fitting workflows in Baha Fitting Software, including BC Direct and Feedback Analyzer, so you may complete an upgrade or replacement device fitting, fine-tuning, and enable programs and processor/program features.

Because of this access to the features and tools in the fitting software, Remote Assist for Baha may be used for counseling, follow-up appointments, troubleshooting, and to fit upgrades and replacement devices, so it is very flexible to fit anywhere into your clinical protocol.

Using Remote Assist:

Counseling session: to complement the first fitting of a new processor or to address your patient’s questions at any time
Follow-up fitting: to substitute an in-clinic session requiring fine-tuning or adding programs
Annual visit: to substitute a routine in-clinic check up
Troubleshooting: when something unexpected happens and the patient requires assistance
Sound processor upgrade fitting: to fit the new processor without the need for the recipient to visit the clinic
Replacement device fitting: to program the replacement processor without the need for the recipient to visit the clinic

Online log-in

Figure 2: Online Login Screen

Technical Measurements

For clinicians interested in conducting device verification of the Baha 6 Max Sound Processor in conjunction with the Audioscan Verifit Skull Simulator, there is a new Technical Measurement workflow which will set up the Baha 6 Max Sound Processor to allow you to compare the device to the published specification. Technical Measurement settings are not for patient use and will only be temporarily available in the sound processor during verification testing. To access this new feature, please select “Technical measurement” on the Setup Tab of the Activity Screen.

Figure 3: Technical Measurement Screen

Battery door selection in BC Select

An update to the BC Select choices include indication of which type of battery door is used on the sound processor being fitted (Tamperproof or Standard). The active choice of battery door in the fitting software is expected to be a reminder for the clinician to consider the appropriate battery door. While the battery door selection does not impact the prescription, the fitting software will not move forward with programming until the battery door is selected. Once selected, you may program as usual.

Improvements to Indicators

To ensure that tests are run accurately and completely, there have been improvements in indicators for background noise and low battery.

Background noise indicator

When running the Feedback Analyzer, BFS will scan the environment and give a warning if background noise is on a level that could disrupt the measurement.
When entering the BC Direct screen BFS will scan the environment and give a warning if background noise is at a level that potentially could affect the outcome of the measurement.

Low battery warning

For some actions in the software, it is recommended for the sound processor to have full battery capacity. In these cases, the software will give a notification if the battery level is low.
When using the Reset to Out of box settings, the software requires sufficient battery level. In this case the action will be prevented if the battery level is low.

Usability Enhancements

Recalculation or re-prescribe is now triggered only when needed
The patient you are connected to and the workflow you are in will be displayed in the header
In the footer, a green bar is visible when connected. If disconnected during fitting, the bar will go grey and only the sound processor name will be visible

Advanced Logging

There is now an advanced level of logging that can be set in Baha Fitting Software 6.1 when troubleshooting. Advanced debug logging collects more information needed for investigation of issues (i.e., errors and steps taken during programming) to send to Cochlear.

If you would like more information about Baha Fitting Software 6.1, please reach out to your local Cochlear Americas representative or visit the “Software Support” resource section in myCochlear Clinic for the link to register and download BFS 6.1.

^*Remote Assist for Baha is intended for a follow-up adjustment or setup of a replacement or upgrade sound processor for suitable qualified patients based on clinical judgment. Clinic must be enrolled in Remote Care to participate.

^{^}The Baha Smart App works with the Baha 6 Max Sound Processor and compatible Apple and Android devices. For compatibility information visit www.cochlear.com/compatibility.

^#Contact your local Cochlear representative for more information about Cochlear Professional login credentials.

This content is meant for professional use. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information. Views expressed are those of the individual. Consult your health professional to determine if you are a candidate for Cochlear technology.