Services & Support
by Jamie Schwartz

Update: Billing commercial insurance

February 6, 2018
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Cochlear’s commitment to our customers to “Hear now. And always” drives us to enhance the way we provide service each and every day. In alignment with this commitment, we are proud to announce a major update to the way your patients will access Cochlear parts and accessories using commercial insurance.

Enhanced Commercial Insurance Services

Many of your patients have asked us to provide insurance reimbursement services to support claims for Cochlear parts and accessories* (that cannot be purchased elsewhere such as Cochlear Rechargeable Batteries), repairs and other medically necessary components.

After more than a year of development, these new enhanced reimbursement services will begin to roll out starting February 1, 2018 for a range of national insurance providers. Patients who participate in one of the insurance plans with whom we are now contracted can utilize Cochlear to bill insurance on their behalf – alleviating the challenge of fighting for pre-authorization, out-of-network benefits, and coverage on their own.

Though we are not contracted with all insurance providers at this time, we are actively pursuing new provider contracts every day. A list of insurance providers with whom we are contracted can be found online at the following URL and will be updated as new providers are added:  www.Cochlear.com/US/InsuranceList

Thank you for allowing Cochlear to partner with you to bring the gift of hearing to so many people each day.

If you have any questions, please contact your Customer Care Representative.

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Author

Jamie Schwartz

Jamie is the Associate Marketing Manager in the Product and Professional Marketing Department at Cochlear Americas. Jamie is responsible for ProNews blog content as well as professional social posts and calendars. If you are interested in being a guest author for the ProNews blog please contact Jamie by email at jschwartz@cochlear.com.

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Counseling

Identifying upgrade eligible patients with Custom Sound Pro

July 11, 2022

By Kyle Longwell, Product Manager – Software and Clinical Care

We know one of the most exciting things about Cochlear technology is that it continues to evolve. Next-generation sound processors are designed to deliver clearer sound, new connections and capabilities and work with a patient’s existing implant.

When patients are considering an upgrade to newer technology, one of their main considerations is improvement in hearing performance. In addition, your patient’s insurance company has considerations for when a sound processor upgrade is medically necessary for patients. 

Patients are typically deemed eligible for a medically necessary sound processor upgrade by their insurance company when their device is out of warranty, and one or more of the following occurs:

  • The device has reached its “end of useful life”—usually after five or more years of continuous use
  • The device is lost or irreparably damaged
  • The device is retired or obsolete, which is a normal part of a product life cycle that occurs as technology advances
  • There is a demonstrated improvement in hearing performance with next-generation technology

As with all technology, there is a set time period that it is likely to remain in service before newer technology supersedes it. Many insurance plans, including Medicare and Medicaid, may authorize the replacement of a sound processor when it has reached or passed a stated period of “useful life,” usually five years.

As new technology is developed, older sound processors may become outdated and retired. Cochlear may decide to phase out production and support of aging technology, after which time, parts and accessories may no longer by available.

We know it may be a challenge to identify patients who might be ‘upgrade eligible’ and want to provide a few tips that might help along the way. Custom Sound® Pro fitting software has useful tools built in to help you identify patients who have reached the “end of useful life” of their sound processor and might be ready for an upgrade. Using Custom Sound Pro, you can identify individual patients and also pull a report to proactively identify groups of patients who have had their sound processor for more than five years.

When opening a specific patient record in Custom Sound Pro, you may see a notification on the patient dashboard which will indicate that an individual patient has had their sound processor for more than five years, and that newer technology might be available to benefit the patient. You will see a yellow ‘!’ icon to indicate this notice. You can ignore the notification (no specific action required) or dismiss by opening the pop-up message and clicking Dismiss, but the icon itself can serve as a hint that the patient is in outdated technology.

Another available tool in the fitting software is the Device Status Report located in the Tools menu of Custom Sound Pro which can be used to generate a spreadsheet of your clinic database including patient sound processor type and fitting date. After clicking on Device Status Report, an Excel file is generated from non-archived patients within the database that can be sorted and filtered, based on clinician preference. The information in the report (namely, Latest_Sound_Processor_Model and Years_Since_Earliest_Session_Date) can be another useful way to identify patients that may benefit from newer technology.

When your patients are ready to upgrade to newer technology, Cochlear has a host of resources available to help patients understand how to upgrade and the steps needed to upgrade their Cochlear sound processor. Whether patients prefer to self-pay for their new sound processor or utilize their insurance benefits, Cochlear’s specialists can help walk through the process, get their order started and navigate their insurance, if applicable.

Read more about the benefits of upgrade technology.

Adult rehab

Time to rethink adult rehab

March 2, 2021

Review Prepared by Janette Oliver, Global Outcomes & Rehabilitation Manager, Cochlear Limited, BA., Dip Teach., M.Ed., PG Dip.Ed(Hearing Impaired) Dip.Aud., MA., MAudSA,CCP, Cert AVT

Hearing loss is complex and impacts on every aspect of a person’s life. The aim of aural rehabilitation is to help improve an individual’s quality of life through optimizing hearing function and communication.

To do this in a meaningful way we need to move beyond the assumption that device fitting alone is enough.

This assumption may discourage adult cochlear implant recipients from seeking appropriate aural rehabilitation and is often the reason why passive exposure is commonly recommended to recipients in clinics.

As a result, adult cochlear implant users typically adapt to the implant passively through everyday exposure to routine sounds in order to accurately pair an auditory stimulus to meaning.1

However, while device fitting alone may lead to improved hearing outcomes, a more holistic approach to rehabilitation which also addresses combined perceptual and cognitive skills training, knowledge acquisition and counseling will support broader real-life listening and communication outcomes. 2,3

Holistic care

A holistic approach is also shaped by the requirements of the individual – their needs, abilities, social and physical contexts and preferences.

Several researchers have also argued that hearing loss needs to be managed under a model of care that follows on from the World Health Organisation ICF framework for intervention and treatment of disability.4

This framework not only considers the physical hearing impairment (fitting appropriate technology), but also:

  • The impact it has on the individual in terms of activity limitations (such as inability to perceive speech in noisy environments)
  • Participation restrictions (such as the ability to fully participate in conversational activities)
  • Quality of life (includes such things as enjoyment and independence)5

More recently, Moberly et al (2020) proposed a comprehensive auditory rehabilitation approach along similar lines, incorporating device fitting and management, instruction, counseling and auditory training maximizes the opportunity to optimize speech recognition and quality of life outcomes for adult cochlear implant users.6

The pilot study conducted by this group demonstrated that such an holistic approach is feasible with adult cochlear implant users. A larger-scale trial is recommended by the authors to demonstrate the efficacy of this comprehensive auditory rehabilitation (CAR) approach as compared to current standard-of-care or additional preoperative counselling.

Read more about rehabilitation now!

References:

1. Drouin, J. R., & Theodore, R. M. (2020). Leveraging interdisciplinary perspectives to optimize auditory training for cochlear implant users. Language and Linguistics Compass. https://doi.org/10.1111/lnc3.12394 

2. Boothroyd, A (2007). Adult aural rehabilitation: what is it and does it work? Trends Amplif. 2007 Jun;11(2):63-71.    

3.Ferguson, M., Maidment, D., Henshaw, H., & Heffernan, E. (2019). Evidence-Based Interventions for Adult Aural Rehabilitation: That Was Then, This Is Now. Seminars in hearing, 40(1), 68–84. https://doi.org/10.1055/s-0038-1676784]   

4. McMahon, C, Gopinath, Schneider,J, Reath,J., Hickson,L, Leeder,S., Mitchell, P., Cowan, R. (2013) The Need for Improved Detection and Management of Adult-Onset Hearing Loss in Australia. International Journal of Otolaryngology Volume 2013, Article ID 308509, https://dx.doi.org/10.1155/2013/308509]

5. [https://www.who.int/classifications/international-classification-of-functioning-disability-and-health]

6. Moberly, A. C., Vasil, K., Baxter, J., Klamer, B., Kline, D., & Ray, C. (2020). Comprehensive auditory rehabilitation in adults receiving cochlear implants: A pilot study. Laryngoscope Investigative Otolaryngology. https://doi.org/10.1002/lio2.442.

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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.

 

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