We hope you’ve already heard, but in case you haven’t, this February we announced that Oticon Medical has obtained accreditation as a Medicare Durable Medical Equipment Supplier.
The accreditation process aims to ensure that Medicare beneficiaries have access to high quality items of durable medical equipment and is part of the federal agency’s larger vision to foster a health care system that ensures quality care for all persons on Medicare. To earn this accreditation, Oticon Medical met quality standards that addressed such factors as product quality, business integrity, accountability and performance management.
We want to take the opportunity to explain exactly what this means for you.
This means that Oticon Medical can now bill Medicare directly for bone anchored processors for those who qualify for Medicare coverage. This helps us in our goal to create new possibilities and more choice in bone anchored hearing solutions.
“As a Supplier, we are uniquely positioned to assist hearing health care providers in extending the potential for treatment and successful outcomes to more patients than ever before,” said Curt Gorman, Oticon Medical US President.
Curt explains that for the past few years, Medicare, or CMS (Centers for Medicare and Medicaid Services), has focused on reducing waste and fraud. As a result, they have stepped up the accreditation process in order to be able to sell durable medical equipment to Medicare patients directly. This change applies to replacement processors, batteries and things that the patient may need to purchase after they have already received the surgery and been fit with the device.
“For our company, now that we are certified as a Medicare Durable Medical Equipment Supplier, patients who have Medicare can purchase equipment directly from us, and we will bill Medicare,” Curt explained. “For example, a patient may need a new processor. That patient can purchase the processor through us, we will bill Medicare, and then the patient can take the processor to an audiologist to fit it.”
How does this work for patients?
Curt takes us through the process: “The patient would get a prescription from her doctor as the processor is a prescriptive device. Then the patient would call us, so that we can get some information from the patient to process the order. Once we get the prescription and the paperwork completed, we send the processor to the patient, obtain confirmation from the patient that she indeed received it, and then we bill Medicare. Once the patient receives the processor, they are responsible for getting it programmed from their audiologist, and for any fitting fees for the programming.”
Typically, patients return to the clinic where they were originally implanted. However, there are some clinics across the country that are very large and cater to patients from all over the country. Some patients who were originally fit at specialized clinics may live quite a distance away. In these cases, patients can use the clinic finder on our website to find a location to have the processor fit.
How do you know when you need a new processor?
“Approximately 30 percent of people who use bone-anchored hearing systems because of conductive hearing loss; the other 70 percent have single-sided deafness (SSD). We know that as with many patients with hearing loss, with SSD the hearing in the better ear may change over time, i.e., worsen as the patient gets older. When the hearing changes, a more powerful processor may be in order,” Curt said.
Also, technology has advanced very rapidly, and there are new products with new features. Medicare will cover a new processor once every five years or until the processor is no longer useful. For patients whose hearing has changed, or that have a processor that is over five years old they can explore upgrading here.
Would you like more information about insurance coverage? You can find all of the information you need on our insurance support page here. And, you can always find a clinic near you here.
If you have Medicare coverage and are looking to replace your current bone conduction processor, please contact us at 1-888-277-8014 or email us at [email protected] You can also find us on Facebook and ask your questions on Twitter too.