Tag Archives: Medicare

Bethany Geldmaker Advocates for Awareness & Continued Coverage

Bethany Geldmaker has an incredible story. Paired with the impactful way that she advocates for the importance of bone anchored hearing systems and her mission to educate others on the process of getting coverage for their bone anchored hearing systems, she’s one of the most powerful voices in the community. Recently, Bethany has accelerated her efforts even more to bring awareness to the changes that The Centers for Medicare and Medicaid Services (CMS) have proposed that could eliminate coverage for bone anchored hearing devices in 2015.

Our collective rebuttal to the proposed changes must be education that helps people understand just how important it is to keep coverage for bone anchored hearing systems. That’s exactly what Bethany has been doing. She’s been doing this in three key ways:

  • Working to heighten public awareness
  • Encouraging others to educate themselves on solution options
  • Getting information and education in the hands of insurance providers

Here’s Bethany to explain how she works to accomplish these three goals.

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Andrea Dowell Opposes Change to Medicare Coverage for Bone Anchored Hearing Devices

Ten-month-old Ashlyn, who was born without ears, would be deaf without her bone anchored hearing system. Like so many, the system is critical to her development and wellbeing.

Her mother, Andrea Dowell, is speaking out and opposing the change to Medicare coverage that could eliminate coverage for bone anchored hearing systems.

“It means a lot to a lot of people.”

A bone anchored hearing device is the only answer for her daughter.

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An Important Message to Bone Anchored Hearing System Users, Advocates & Families

As you may have heard, The Centers for Medicare and Medicaid Services (CMS), the governing body that runs Medicare, is proposing to eliminate the coverage for bone anchored hearing devices in 2015. The proposal’s aim is to classify bone anchored hearing systems as hearing aids, which are specifically not covered under Medicare. If this proposal is passed, it will effectively terminate all Medicare coverage for new bone anchored implant surgeries as well as terminate funding for replacement processors for current bone anchored implant users under Medicare.

MedicareEqually disturbing is the potential ripple effect this proposal will have on non-governmental private payers and state Medicaid policies. These groups routinely look to Medicare as the standard for their policies and use Medicare coverage guidelines for justification of coverage, or removal of coverage for treatment options. It is not overstating a concern to say if this proposal passes, coverage for everyone using a bone anchored system is threatened.

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Oticon Medical Now A Certified Medical Durable Equipment (DME) Provider

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 info@oticonmedicalusa.com. You can also find us on Facebook and ask your questions on Twitter too.