Services & Support
by Cochlear Guest Author

Fostering patient self-managed care and device confidence with Cochlear Recipient Solutions

November 27, 2023
Share

By Elizabeth Sweet, Au.D, University of Pennsylvania Health System, Perelman Center for Advanced Medicine

With more candidates being referred for hearing implants than ever before, it’s imperative for clinics to reexamine clinical efficiency in order to meet the growing demands and adapt to the changing landscape of the hearing health industry. Recent data show that:

  • Nearly all patients report that they are now comfortable with the use of telehealth for non-emergency care1
  • 85% of adults aged 50+ own a smartphone and the technological gap between younger and older patients is closing2

Self-managed care, as part of Connected Care solutions, empowers your patients to actively manage their hearing outcomes in partnership with you, receiving care when and where they need it using the latest in digital technology.

This case study explores how the Cochlear Recipient Solutions Manager (RSM) Program can help enhance patient outcomes by fostering self-empowerment through a personalized and easy to use program, the linchpin of evolving patient expectations. This team of trained Cochlear professionals ranging from AuDs, SLPs, educators and beyond, provide a best-in-class virtual learning experience for new hearing implant recipients looking to increase confidence with their new devices and to achieve hearing goals.

Read on to hear from a fellow clinician:

Setting the scene

Your patient has decided to pursue a cochlear implant. They’ve undergone surgery and healed, and now they’re in your office for activation! You’ve finished your programming for your patient, they’re hearing sounds again and now the time has come to show them how to use their devices.

With your eight years of education in Audiology and multiple years of clinical experience, you could likely change batteries and pair a Mini Microphone 2+ in your sleep! Your patient, however, maybe has seen these devices in person or online only once. They’re trying to acclimate to this new way to hear while also absorbing all of the information on these devices that they are expected to use on their own. This is why activation appointments can sometimes feel overwhelming for you and your patients as there is a long list of topics to cover.

Instead of rushing through all these topics, I decided to change my approach – I now program and demonstrate enough that the patient can go home and use their new device then schedule an appointment with our local Cochlear RSM to cover the following:

  • Programming
  • Counseling on how to charge batteries
  • Teaching patients how to use the Zephyr Dry & Store
  • Practicing how to put on the sound processor
  • Registering for a Cochlear Account
  • Setting up phone streaming
  • Explaining progressive MAPs
  • Discussing the extensive list of other topics that our patients need to know about their new devices

Within a few weeks, I found that patients were returning to me with less questions and expressing feeling more confident with their devices which, in turn, gave us more time for programming and evaluating progress.

Below, I outline the story of a patient with whom my RSM and I partnered together to provide quality care.

Case study

Meet John (name changed for privacy):

John is a 67-year-old man who recently retired from a corporate job. He now spends his time with his grandchildren and tutoring high school students in math. When I met him for his candidacy evaluation appointment, he was utilizing binaural amplification but was interested in learning about cochlear implants. Though he reported struggling to hear on the phone during these activities, he did not believe his hearing was “bad enough” at that point to really consider surgery.

Following testing and counseling, John decided to pursue cochlear implantation with two Nucleus® 8 Sound Processors, the Mini Microphone 2+, TV Streamer and an extra rechargeable battery. His surgery went well and before we knew it, he was back for activation. John is a real go-getter and he approached the cochlear implant process wanting to learn and do all that he could to be successful.

On activation day, I created John’s initial MAP and counseled him on how to change/charge his batteries, how to put on his device and how to move through his progressive MAPs. We scheduled his appointment with our local RSM to review what we had talked about as well as other topics he was eager to learn about.

At the end of our appointment, he expressed feeling “excited but overwhelmed.” One week later, John arrived at his next follow-up expressing confidence in his ability to use his devices. He had paired his processor to his phone, started aural rehabilitation using the Cochlear Copilot app and was all ready to begin using his Mini Microphone 2+ during his tutoring sessions to better hear the students around him! Accessories can seem to get pushed to the wayside to allow for more programming and counseling on the basics, but because of his appointment with an RSM, John was in a more secure spot than he would have been if I had squeezed all of that information into our short time together. When asked about his experience with the RSM, John said, “ It made me much more comfortable with the processor and I’m able to hear the TV very well without blasting my wife out of the room!” It was a great feeling to see John expressing confidence and independence in such a short time.

Outcomes

The progress John displayed so quickly is now the norm for many of the recipients I see and it is thanks to the support from our RSM. The Cochlear RSM Program has become invaluable in my personal practice as it gives patients the tools to cultivate independence with their devices, and therefore lessen the load placed on our clinic. I can spend more time on what is most important to the patient and in many cases, save them an extra trip to the clinic to discuss topics that the RSM is more than qualified to handle. My RSM has become instrumental in the success of my recipients and saved me valuable time and resources.

Learn about all of the support services that Cochlear provides to help our partners be successful: 2023 Connected Care and Service Report

It’s easy to schedule an appointment with your local RSM on behalf of your patient. Click here to start!

About the author:

Elizabeth Sweet, Au.D, CCC-A is a doctor of audiology within the Division of Audiology in the Department of Otorhinolaryngology Audiology-Head and Neck Surgery. She has clinical expertise in the diagnosis and management of hearing disorders, hearing aids, and cochlear implants. Dr. Sweet strives to provide compassionate and personalized care to improve the quality of life for her patients.

  • Doctor of Audiology – University of Pittsburgh, Pittsburgh, PA
  • Bachelor of Arts – University of Pittsburgh, Pittsburgh, PA
  • Member of the American Academy of Audiology
  • Certificate of Clinical Competence in Audiology, American-Speech-Language and Hearing Association
  1. Predmore ZS, Roth E, Breslau J et al (2021) Assessment of patient preferences for telehealth in post-COVID-19 pandemic health care. JAMA Netw Open, 4(12):e2136405
  2. Kakulla B. (2021) Tech Trends and the 50-plus: Top 10 biggest trends [Internet]. Washington DC: AARP Research, 20212. [cited 2021 Nov 24]. Available from https://doi.org/10.26419/res.00420.001
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.

View all posts

Related Posts
calculating at desk

NCCI (National Correct Coding Initiative) edits: the purpose and impact on claims processing

March 21, 2019

Reimbursement

By guest author: Anne Anthony

Has this ever happened to you? You had a full day of clinic appointments performing a variety of professional services for patients. The claims for these appointments were filed and processed, and the remittances or explanations of benefits from the insurance plan stated that some of the services performed were denied “due to NCCI edits”. What does that mean?

NCCI stands for the National Correct Coding Initiative (NCCI or CCI), which was implemented by the Centers of Medicare and Medicaid Services (CMS) to promote national correct coding methodologies and to control improper coding leading to inappropriate payments for Part B provider claims. When certain codes are submitted together on a single claim, the NCCI code pair edits (known as the Procedure-to-Procedure or PTP code pair edits) are automatically applied during claims processing to prevent improper payment for incorrect code combinations. While certain CPT (Current Procedural Terminology) codes are very specific in the description of a single service, others may describe a procedure that consists of many services. Because these code descriptors may not list every service included in a specific procedure, providers may be unsure when services are considered inherent to the primary, more comprehensive procedure performed during the patient encounter.

CMS publishes tools to help providers avoid coding and billing errors and subsequent payment denials. Along with the NCCI manual, providers may also find the Medicare Learning Network booklet helpful on how to use these tools. The NCCI tables and PTP code pair edits are updated quarterly. These updates help identify services that may be considered a component of the more comprehensive primary service; those that may be mutually exclusive of each other and unlikely to be performed at the same encounter, or those potentially separate and distinct services which may be payable if the use of a modifier is justified.

Now you may be asking, how do I know if a service is considered a component of another service I perform? The PTP code pairs are presented in the NCCI tables with CPT codes under columns labeled Column 1/Column 2 within the PTP code pair tables. When a code pair is submitted on a claim, the Column 1 code may be eligible for payment while the Column 2 code may be denied. In some scenarios, a provider may be eligible for payment of both codes if each service is considered clinically appropriate and an appropriate coding modifier is appended. Modifiers should only be appended if the clinical circumstances justify the use of the modifier and the patient’s medical record includes documentation to support the utilization. Never append modifiers to a CPT code to merely bypass a PTP code pair edit. Rather, indicate that a clinical rationale has been identified and documented. The PTP code pair tables also provide helpful guidance on the appropriate utilization of modifiers, including information on the potential applicability for the code pair, or lack thereof, in the form of a modifier indicator, as shown in the example below.

Table 1

Below is a partial excerpt from the CMS NCCI Practitioner procedure edits table highlighting a few audiology service code pairs. The procedure listed in Column 1 represents a primary service performed, while the procedure in Column 2 represents the subsequent service(s). Whether or not a modifier may be applicable or allowed is shown by the indicator of 0, 1, or 9 in the far right column.

Table 2

PTP Coding Edits

Understanding the nuances of reimbursement is only one aspect in building a sustainable practice. Cochlear offers support to providers to help navigate these areas. Please visit the Cochlear Reimbursement Solutions website to identify your Cochlear Regional Reimbursement Manager or call the Cochlear Coding Support Program at 1 800 587 6910 for additional information.

About our guest author:

Anne Anthony is one of three geographically-based hearing implant reimbursement experts available to assist you with coding, payment, payer coverage, contracting, and other reimbursement related challenges. Anne’s contact information, along with that of her colleagues and a more detailed description of the reimbursement support offered by Cochlear’s Regional Reimbursement team, can be found on the Reimbursement Support page of Cochlear’s US Professional Resources Website. Please do not hesitate to reach out to the Reimbursement Manager associated with your geography for reimbursement assistance or for questions related to this article. Cochlear offers coding assistance through the Coding Support Line accessible by calling 1-800-587-6910 between the hours of 8 AM – 3 PM Mountain time zone or via email at codingsupport@cochlear.com. For pre-surgical insurance support, OMS is available to assist with pre-authorizations and appeals and can be reached at 1-800-633-4667 option 4.

This information is provided as a set of guidelines only to address the unique nature of implantable hearing solutions technology and is not intended as legal advice. There is no guarantee that following these guidelines will result in any form of coverage or reimbursement from any insurance company or federal health care program payer. The information presented herein is subject to change at any time and may become outdated. This information cannot and does not contemplate all situations that the health care professional/provider may encounter. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own coding advisors and payers to verify that the information provided herein is applicable to your needs. Seek your own legal advice regarding your reimbursement needs and the proper implementation of these guidelines. All products should be used according to their labeling. In all cases, services billed must be medically necessary, actually performed, and appropriately documented in the medical record.

Cochlear Americas First Annual Service Report

August 20, 2020

We’re proud to introduce Cochlear Americas’ First Annual Service Report.

For almost 40 years, Cochlear has been bringing people all over the globe into a world of sound. During that time, we have brought innovation in both our technology and our supporting services. Cochlear Care is a portfolio of services built on feedback and designed to keep our patients and our professional partners’ needs in mind.

Our innovative and personalized service offering covers the entire professional and patient journey inclusive of education, insurance support, technical support, community connection and hearing therapy. Cochlear has pioneered web, portal and cloud-based services for hearing implant recipients that are now accessible 24/7 and personalized to the patient or clinic. We value and utilize feedback to evolve as an organization and continuously develop services to meet the needs of our partners.

In this report, we illustrate how our portfolio of services keeps our mission at the heart of all we do. The report does not include every service that Cochlear offers but rather, highlights services that support the patient journey, the professional experience and the services that connect patients and professionals virtually.

For more information, read the Service Report here.

Cochlear logo - white

©Cochlear Limited 2024. All rights reserved. ACE, Advance Off-Stylet, AOS, Ardium, AutoNRT, Autosensitivity, Baha, Baha SoftWear, BCDrive, Beam, Bring Back the Beat, Button, Carina, Cochlear, 科利耳, コクレア, 코클리어, Cochlear SoftWear, Contour, コントゥア, Contour Advance, Custom Sound, DermaLock, Freedom, Hear now. And always, Hugfit, Human Design, Hybrid, Invisible Hearing, Kanso, LowPro, MET, MP3000, myCochlear, mySmartSound, NRT, Nucleus, Osia, Outcome Focused Fitting, Off-Stylet, Piezo Power, Profile, Slimline, SmartSound, Softip, SoundArc, True Wireless, the elliptical logo, Vistafix, Whisper, WindShield and Xidium are either trademarks or registered trademarks of the Cochlear group of companies. The names of actual companies and products mentioned herein may be the trademarks of their respective owners.

 

This material is intended for health professionals. 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.

 

Cochlear ProNews is monitored Monday through Friday, excluding some holidays. Questions and inquiries submitted over the weekends or holidays may see a delay in response. For immediate assistance please contact us directly. You are solely responsible for your interactions with other members of our Websites. Cochlear reserves the right, but has no obligation, to monitor disputes or communications between you and other members of our Websites. For a full list of Cochlear’s terms of use, click here.