Services & Support
by Cochlear Guest Author

Help your patients maximize 2024 insurance benefits with Cochlear

July 23, 2024
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We’re past the half-year mark—it’s a great time for eligible patients to consider using their 2024 insurance benefits to replace their CochlearTM sound processor.  

Cochlear will be reaching out to recipients who have been in their current sound processor technology for more than five years, one of the main criteria for determining eligibility for a sound processor replacement through insurance, and who have provided consent for communications from Cochlear. 

Encourage your patients and their caregivers to plan ahead if they want to use their 2024 insurance benefits. 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 2024 to ship by the end of the calendar year, and the last day that Cochlear will be shipping orders is December 27, 2024. We recommend placing replacement sound processor orders no later than October 31, 2024. †

We know that patients will reach out to you for help in this process.  Cochlear is here to help you both.

Eligibility

The first step is to determine if your patient might be eligible for a sound processor upgrade.  Did you know you can use Custom Sound Pro to identify if your CI patient has been using their sound processor for five years or more, which is one of the main criteria for determining eligibility?

Order Placement

If your patient is ready to place an order and does not need pre-upgrade counselling, they can:

  • Log into their Cochlear account and place an order via the online Cochlear Store, which is recommended for patients who are active users of the Nucleus Smart App.* Orders can be billed to insurance.
  • Call Cochlear at 1-800-483-3123.

Pre-Upgrade Counselling

If your patient has been in their sound processor for five years and wants help along the upgrade journey, they can schedule a virtual Upgrade Consultation with Cochlear’s team of experts.  Upgrade Solution Specialists can help your patients learn more about eligibility, what sound processor is optimal for them, the upgrade process and potential costs, and benefits of new technology. Cochlear will keep you informed via a Clinic Patient Report for patients who provide consent. 

CI Upgrade Resources for Professionals 

To help make this as seamless as possible for you and your patients along each phase of the replacement sound processor journey, Cochlear created resources and support for professionals, including a detailed protocol.   

Programming Upgrades for CI and Baha

Ready-to-Wear (RTW) for Nucleus Sound Processors

RTW is free of charge and allows your patients to begin wearing their device immediately without a separate trip to the clinic.+  You can learn more about Ready-to-Wear here.

Remote Assist for Baha 6 Max Sound Processors

Audiologists can program new sound processors remotely using Remote Assist.  For more information about our Connected Care resources, visit our webpage.

Cochlear is here to help you and your patients navigate the sound processor replacement process.

†Orders placed on or before October 31, 2024 are not guaranteed to be approved by an insurer or shipped on or before December 27, 2024, 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.

* The Cochlear Nucleus Smart App is available on App Store and Google Play. For compatibility information visit www.cochlear.com/compatibility

+ To participate, recipient must be age 5 years or older. The Ready-to-Wear service is not available for hybrid externals, Kanso to Nucleus 8 Sound Processor upgrades and certain implant types.  For clinics utilizing Cochlear™ Link, you can review and adjust your Accepted Map Age (AMA). Patients requesting Ready-to-Wear service with their upgrade will automatically receive the service if it falls within the AMA. For clinics who do not use Cochlear™ Link, or for patients with a MAP that exceeds the AMA, you will be receive notification within myCochlear Professional to approve a RTW request. For more information on Cochlear™ Link or to update your clinic’s AMA please contact CochlearLink@cochlear.com  Upgrading bimodal ReSound patients: for recipients with a compatible ReSound hearing aid# to take advantage of smart bimodal streaming, they will need to visit their clinician to have the hearing aid and sound processor re-linked. 

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.

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, AL, CA, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MS, MT, NC, ND, NE, NJ, NM, NV, NY, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, and WY.

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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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.

baha fitting

How the Lend an Ear Program can provide your pediatric bone conduction patients early access to sound

May 14, 2020

You know that early access to sound can make all the difference for your pediatric patients. The Cochlear™ Lend an Ear Program was created for children 12 and under who need early access to sound through a bone conduction solution.* Our unique program enables you to fit your patients with a Baha Start System using a Baha® 6 Max Sound Processor while the insurance approval process takes place. With this program, your patients gain access to critical sounds as early as possible to help them hear, learn and develop essential communication skills.

Why choose the Cochlear Lend an Ear Program? It is:

  • Designed for early access to sound. Allow your pediatric patients to meet their hearing needs as soon as possible, prior to obtaining insurance authorization.
  • Designed for convenience. Once insurance approval is obtained, the technology is your patients’ to keep with no further need for equipment exchanges or fitting appointments.
  • Designed for optimal hearing performance. We’ll provide your patients with a Baha Start System. This includes a Baha 6 Max Sound Processor, along with the choice of a non-surgical wearing option (Softband or SoundArc™) and an accessory.
  • Designed to provide premium power. Our Baha 6 Max Sound Processor delivers more power with a fitting range of up to 55 dB SNHL in the same small size as other 45 dB devices and features our most advanced sound processing technology and direct streaming with a compatible smartphone.
  • Designed for peace of mind. Patients can use warranty services that include processor repair and access to one-time theft & loss coverage while insurance approval is pending.
  • Designed to suit your clinic practice and patient needs. Get started with the Lend an Ear Program by choosing the insurance billing option that works best for your clinic and patients:
    • Option 1: Cochlear’s Reimbursement and Insurance Services bills insurance
    • Option 2: Your clinic bills insurance

Get started

Get started with Option 1: Cochlear’s Reimbursement and Insurance Services bills insurance

  1. Discuss the program with your patient and caregiver using the Lend an Ear counseling resources.
  2. Submit the order to reimbursement@cochlear.com by completing the following two forms with your patient’s caregiver so you can easily customize the order depending on what suits your patient the best:
  3. Your patient’s sound processor will be shipped in a matter of days!
  4. We’ll reach out to you and your patient for additional documentation after we ship the device, including a Letter of Medical Necessity (LMN), clinical documentation and any other documentation necessary to complete the order.
  5. Once insurance approval is obtained, we’ll ship your patient’s system accessory and full ownership of the device will be transferred to them.

Get started with Option 2: Your clinic bills insurance:

  1. Discuss the program with your patient and caregiver using the Lend an Ear counseling resources.
  2. Submit the order to procare@cochlear.com by completing the following form with your patient’s caregiver so you can easily customize the order depending on what suits your patient the best:
  3. Your patient’s full Baha Start system will be shipped in a matter of days!
  4. You’ll follow-up with insurance to obtain approval.

To learn more about the Lend an Ear Program visit AudiologyOnline or email reimbursement@cochlear.com.

* The Cochlear Lend an Ear Program is offered in the United States only and is for pediatric patients who are new to a non-surgical bone conduction solution.

In the United States and Canada, the placement of a bone-anchored implant is contraindicated in children below the age of 5.

The Cochlear Baha 6 Max Sound Processor is compatible with Apple and Android devices.  For compatibility information visit www.cochlear.com/compatibility

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©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.

 

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