Monthly Archives: May 2022

Presidential Perspective

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Sale of Oticon Medical to Cochlear: What Does It Mean?

I’m not going to pretend—this is a tough one, friends.

We recently hosted our annual National Sales Meeting in person for the first time since the pandemic began. It started off filled with excitement over the launch of our Ponto™ 5 SuperPower, anticipation for the launch of our cochlear implants later this year, and the simple joy of getting to interact live with our colleagues again. At the end of Day One, we all went home energized and looking forward to the rest of the meeting.

Then, on the beginning of day 2, I had to tell the team that Demant had decided to discontinue its Hearing Implants business area and reached an agreement to sell Oticon Medical to our biggest competitor, Cochlear™. You can click here to read the official announcement.

That morning is still a blur. Although much remains uncertain about how this process will unfold, one thing is clear—I can commit to you that ensuring the life-long care of Oticon Medical users is our primary focus.

I am still processing this like everyone else. But beyond those of us who work for Oticon Medical, I know the news is already affecting our valued customers and patients. My team has seen your expressions of shock, disappointment, anger, concern, sorrow—all reasonable and understandable emotions. I will attempt to ease your concerns to the best of my knowledge and ability.

A necessary caveat

One of the greatest challenges during the sale of a business, particularly when it and/or the purchaser is publicly traded, is the secrecy surrounding the process. Various business aspects must be negotiated and approved by not only the companies involved, but by stockholders, board members, and government agencies. It is a complex and often lengthy process during which scant information can be shared with the public at large or with most employees.

In the absence of facts, it is human nature to resort to speculation. We want to know, and so we seek clues and signs of where things might be headed and use those to weave our own narratives about the future. While natural and expected, it is an unhealthy practice for everyone involved, as unproven theories and guesswork may be expressed as factual during conversations or via social media.

With that in mind, here are the facts we know today.

What this acquisition means to customers and consumers

Most important of all, our launch of Ponto 5 SuperPower, the smallest, most powerful abutment-level sound processor available continues as usual! Enjoy the first-ever Ponto 5 feedback prevention system in a new, more powerful device.

As part of the transaction, Cochlear has committed to continue servicing existing patients of Oticon Medical now and in the future. This means you can feel comfortable continuing to recommend Oticon Medical products to your patients. In expressing his commitment to Oticon Medical’s customer base, Cochlear’s CEO and President, Dig Howitt, has stated, “…we will seek to ensure that Oticon Medical’s customers and patients continue to be supported with a lifetime of hearing solutions. We will work closely with Demant to ensure a seamless transition of the business to Cochlear to ensure continued access to current Oticon Medical technology for customers and patients in the coming years.” As the global leader in implantable solutions for hearing loss, Cochlear is well-equipped to provide excellent service and support to audiology professional customers and patients.

As for what this means for the future of Oticon Medical’s BAHS and CI technology, it has been publicly stated by Cochlear that it will “develop next-generation sound processors and services that will enable customers to transition to and benefit from Cochlear’s technology platform over time.”

The agreement is expected to be finalized in the second half of 2022. Until the ownership transfers to Cochlear, everyone here at Oticon Medical remains at your disposal and committed to providing the high level of service and support you’ve come to rely on from our company.

Those are all the facts for now. I hope your takeaway is that you can rest assured our team will continue to do our utmost to provide you with the service you need to enjoy better hearing with our Oticon Medical devices during this transitional phase. We thank you for having chosen our company for your hearing care business or personal needs, and for your dedication, passion, and support for our bone anchored and cochlear implant treatments. If you do have questions going forward, please contact your local Oticon Medical representative, or in the US reach out to us at info@oticonmedicalusa.com or 888.277.8014.

Insurance and Bone Anchored Hearing Systems

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Your Frequently Asked Questions, Answered

If you are a practicing audiologist, chances are that you spend some time each week working on billing and reimbursement. Patients want to know what is covered;  you want to get paid for your services and run a profitable business. Audiologists are challenged with maintaining an understanding of billing and coding in an ever-changing healthcare landscape while treating patients using best practices. Your patients rely on you to give them the best service while also maximizing their health insurance benefits.

We know that the billing and reimbursement process can be daunting for busy clinicians. For this blog, we invited Oticon Medical’s Insurance Services Specialist, Brianna Rusay, to answer your most frequently asked questions about reimbursement as they pertain to bone anchored hearing systems (BAHS).

I am new to bone anchored hearing systems. What does my clinic need to prepare for ordering a device for a patient?

Your patient considering a bone anchored device will need to have up-to-date audiological and medical records as they pertain to their hearing loss and diagnosis. They should have a current audiogram performed by a licensed audiologist within the last year and a full medical evaluation by their physician, especially if they are considering surgery. Your patient’s current insurance information should be on file and your office should verify that your practice is in network with their insurance company if you plan to use your patient’s health benefits when ordering the device. You should be prepared to write a letter on your patient’s behalf justifying your choice of bone anchored hearing device as treatment for their hearing loss, and all documentation supporting your choice should be readily available. Finally, your clinic should have an established account with Oticon Medical to proceed with ordering one of our devices for a patient. You can contact your region’s Oticon Medical Clinical Specialist to set up an account with us.

Who looks into the patient’s benefits to see if they have coverage for surgery?

Surgical coverage will depend on both the surgeon and the hospital/surgical center where the surgery is performed. Oticon Medical has a team of insurance specialists who can check benefits and authorization requirements for BAHS surgery, or the hospital/surgical center can request the authorization directly.

Will my clinic be responsible for paying for the surgical supplies? What about the processor?

Reimbursement for the surgery is fully covered with two codes: 69714 and L8690. 69714 is for the BAHS procedure itself and both the facility and the surgeon can bill for this code. L8690 includes the sound processor, abutment, and implant. This code is considered Durable Medical Equipment (DME) and is typically billed by the facility. A DME contract with the insurance company must be in place in order to bill on this code.

What CPT code will I bill for the processor fitting?

Currently, there is no reimbursable code for a BAHS fitting. However, some insurance companies allow the miscellaneous code 92700 to be used for the sound processor fitting. When billing with this code, be sure to include detailed notes about what services will be included for this code and the breakdown of cost.

How will I get paid for my services?

If the insurance company allows it, you may use the miscellaneous 92700 code.  If the insurance company does not cover that code, the patient would be responsible for all fitting costs. Some clinics have chosen to bill the patient a fitting fee for their time spent in fitting the bone anchored sound processor. This fee can vary and can be up to the discretion of the clinic’s billing administrators.

What happens when it is time to upgrade the processor?

Oticon Medical will start the process of upgrades through insurance for your patient. Please refer your patient to our Insurance Services department and we will send them the paperwork to begin processing the request. To process an upgrade request, we will need the following:

  • Two completed intake forms (one from the patient and one from the clinic)
  • A signed prescription for the ordered upgrade (must be signed by a physician)
  • An audiogram (should be within the last year)
  • Medical notes (should be within the last year)

What if the patient is not eligible for surgery?

Many plans still have coverage for BAHS when worn on a softband, though Medicare does consider this a hearing aid and therefore it is not covered. The process for upgrades is the same for new (and upgraded) softband requests. If a patient is interested in wearing a Ponto on a softband, please refer them to our Insurance Services Department so we can begin the process.

What is the CPT code used for a Ponto on a softband?

Whether it is an initial softband request or an upgrade, the HCPCS remains the same: L8692.  This includes the sound processor and the softband.

Contact Oticon Medical’s Insurance Services Department for help

Although you might not know everything there is to know about insurance and benefits, we hope that by increasing your  knowledge and understanding, you feel more confident managing patients and their insurance benefits. If you have any specific questions about insurance benefits as they pertain to Oticon Medical’s Ponto family of devices, please contact our Insurance Services Department at (855) 400-9761 or mailto:insuranceservices@oticonmedical.com.

About the Authors

Brianna Rusay is the Oticon Medical Insurance Services manager. Brianna has a master’s degree in Health Services Administration and over 10 years of health insurance experience. Brianna has worked in both the health care provider setting and the insurance setting, with a primary focus on Durable Medical Equipment.

Dianna Tingle-Gould, AuD, CCC-A is the Clinical Specialist in the Southeast region for Oticon Medical. She has practiced in hospital and neurotology settings in Houston, Texas and Birmingham, Alabama. She completed her training at Auburn University in 2018.

Courtney Smith, M.A., CCC/A, is the Clinical Trainer for Oticon Medical. She in in her 19th year of practicing audiology. She has practiced in private practice and university hospital settings in Las Vegas, NV. She completed her training at the University of Iowa in 2003.