Services & Support
by Kyle Longwell

Identifying upgrade eligible patients with Custom Sound Pro

July 11, 2022
Share

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As new technology is developed, older sound processors may become outdated and retired.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.

Related Posts
Woman on Android

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:

  1. First, the Remote Check feature of the Nucleus Smart App was activated.
  2. 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.
  3. Once the child and family had completed Remote Check, the results were sent directly to us to review within myCochlear.
  4. 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

  1. 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! 
  2. Look at the questions that the software flags for review. These questions and answers will direct you towards determining the appropriate follow-up.
  3. 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.   
  4. 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. 

Read more about Remote Check on Cochlear ProNews or watch this webinar.

Julie Purdy, Ph.D., CCC-A
Julie has been a part of the Diagnostic Audiology team since 2007 and became the manager of audiology in 2014. She earned her doctorate in philosophy at the University of Utah in 1990, specializing in multicultural audiology and aging. Julie received her Master of Science in 1985 and her Bachelor of Arts in 1983, both in communication disorders from Brigham Young University in Provo, Utah. She holds a certificate of clinical competence from the American Speech-Language-Hearing Association, is a fellow of the American Academy of Audiology and is licensed by the state of California. She primarily works at our Main Campus location.

Keri Colio, Au.D., CCC-A, Cochlear Implant Clinical Coordinator
Keri joined Rady Children’s in 2013 and works at the Main Campus location where she serves as the Cochlear Implant Clinical Coordinator. Keri received her doctorate in audiology from East Tennessee State University in 2013 following completion of a four-year residency program. Prior to that, she earned a Bachelor of Arts in audiology from the University of Tennessee. Keri is certified by the American Speech-Language-Hearing Association (ASHA). She maintains an audiologist license from the state of California and serves as a subject matter expert on the Speech-Language Pathology, Audiology and Hearing Aid Dispensers Board. Keri also serves on the Board of Directors for the Society of Ear Nose and Throat Advancement in Children (SENTAC).

* To use Remote Check, a patient requires: latest version of the Nucleus Smart App (Remote Check is part of this App) running on a compatible Apple device (iPhone or iPod Touch); Nucleus 7 Sound Processors with implant models: CI24RE, CI512, CI513, CI522, CI532, CI612, CI622 and CI632; compatible firmware on the Nucleus 7 Sound Processor (4.1.3.3 or later). A clinician requires access to Cochlear’s secure web-based myCochlear.com Professional Portal to access and review patient results. The recommended browser for accessing the Professional Portal is Google Chrome. A clinician also requires Custom Sound 5.1 or later software to upgrade the patient’s firmware to enable access to Remote Check. For sound processor and app compatibility information, visit https://www.cochlear.com/compatibility.

Remote Check does not replace clinical care and does not involve remote programming of the sound processor.

Remote Check is intended for ages 6 and older. The Remote Check feature is only visible and accessible if the feature is enabled by a clinician. Clinicians should consider the suitability of the feature before enabling Remote Check.

reimbursement

Expanded Medicare telehealth services

May 18, 2020

By Kalisha Barrett, Senior Manager Health Policy

On April 30, 2020, the Centers for Medicare & Medicaid Services (CMS) announced new rules to further expand telehealth for Medicare beneficiaries. CMS will temporarily reimburse audiologists and speech-language pathologists (SLPs) for providing telehealth services to Medicare Part B beneficiaries, in response to the COVID-19 pandemic. This expansion is retroactive to March 1, 2020 and will continue throughout the duration of the COVID-19 public health emergency (PHE).

What does this mean for enrolled Medicare providers?

  • Providers may no longer enter into private payment arrangements with Medicare beneficiaries for any services that are included on Medicare’s approved telehealth services.
  • If any covered telehealth services were provided to Medicare beneficiaries in a private pay arrangement since March 1, 2020, the providers should refund patients and instead submit a Medicare claim.

What does this mean for unenrolled Medicare providers?

  • Providers may not enter into private pay arrangements with Medicare beneficiaries for covered telehealth services provided from March 1, 2020 and during the PHE.
  • Providers should refund beneficiaries for funds collected that were associated with covered telehealth services for services provided since March 1, 2020.
  • Unenrolled providers may not submit claims to Medicare for reimbursement for covered telehealth services during the PHE.

CMS added the following codes to allow audiologists to provide Medicare telehealth services to cochlear implant recipients:

CPT CodeCode Description
92601Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming
92602Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming; subsequent programming
92603Diagnostic analysis of cochlear implant, age 7 years or older; with programming
92604Diagnostic analysis of cochlear implant, age 7 years or older; with programming; subsequent programming

CMS added the following codes to allow SLPs to provide Medicare telehealth services:

CPT CodeCPT Description
92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual
92508Treatment of speech, language, voice, communication, and/or auditory processing disorder; group
92521Evaluation of speech fluency (eg, stuttering, cluttering)
92522Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);
92523Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)
92524Behavioral and qualitative analysis of voice and resonance

As a part of CMS expansion of services, speech-language pathology services can be provided via telephone-only when the patient does not have access to audiovisual equipment.

Both audiologists and SLPs should bill the same CPT codes they would for an in-person appointment, along with the place of service code that represents the in-person service. Providers will need to append the modifier -95 (synchronous telemedicine service) to each CPT code provided via telehealth. During the PHE, Medicare will reimburse these telehealth services at the same rate as in-person services paid under the Medicare Physician Fee schedule for Part B services.  

The American Speech-Language-Hearing Association (ASHA) , the American Cochlear Implant Alliance (ACIA), and the American Academy of Audiology (AAA) have published additional guidance on Medicare telehealth services during the COVID-19 pandemic. It is important to note that the professional societies were instrumental in working with CMS to advocate for expanded Medicare telehealth service for audiologists and speech language pathologists. Providers are encouraged to support their professional societies as they continue to advocate for permanent expansion of telehealth services in the regulatory framework.

To learn more about providing telehealth services, check out these additional resources:

AAA

https://www.audiology.org/advocacy/cms-expands-list-medicare-eligible-telehealth-providers-include-audiologists

ACIA

Covid 19 updates and resources available to providers, including template to request a Medicaid Waiver for providing speech language and audiology services via telehealth.   https://www.acialliance.org/page/covid-19updates

ASHA

Providing Teleheath Services Under Medicare During COVID-19 Pandemic:

https://www.asha.org/Practice/reimbursement/medicare/Providing-Telehealth-Services-Under-Medicare-During-the-COVID-19-Pandemic/#Coding

Telehealth coverage tracking by state:

https://www.asha.org/uploadedFiles/State-Telepractice-Policy-COVID-Tracking.pdf

Telehealth coverage tracking by commercial insurance plan:

https://www.asha.org/uploadedFiles/COVID-19-Commercial-Insurance-Telepractice-Policy-Tracking.pdf

Telehealth coverage tracking of Medicaid by state:

https://www.asha.org/uploadedFiles/COVID-19-State-Medicaid-Telepractice-Policy-Tracking.pdf

CMS

COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers:

https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf

Covered telehealth services during COVID 19 PHE:

https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes

To stay up to date on the latest industry topics, subscribe to Cochlear ProNews and share with your peers.

All specific references to CPT codes and descriptions are ©2020 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. CPT and CPT material are copyrights of American Medical Association (AMA): CPT Copyright 2020 American Medical Association, all rights reserved. CPT is a registered trademark of the American Medical Association. The information provided in this document is provided as guidelines only to address the unique nature of implantable hearing solutions technology. This information does not constitute reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding this information or its completeness, accuracy, fitness for any purpose, timeliness, or 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. This information cannot and does not contemplate all situations that a health care professional may encounter. 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 and coding 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 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.