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The Ponto 5 SuperPower

Technical Tips from Auditory Technical Services

We launched the much-anticipated Ponto™ 5 SuperPower in May. Clinicians and patients alike have been eager to experience the smallest, most powerful abutment-level bone anchored hearing device on the market. For this blog, we asked Auditory Technical Services to provide some tips for clinicians to consider when they are fitting this brand-new device.

What software do I need to program the Ponto 5 SuperPower?

There is a new update with Genie Medical BAHS for the Ponto 5 Superpower. You will need Genie Medical 2022.1. This can be obtained by using the Genie Medical (GM) Updater in your hidden icon menu. You can right-click to start the download and installation.

If GM Updater does not work for you or you cannot find it, feel free to call Auditory Technical Services at 888.277.8014 and choose Option 4 when prompted. We can send the software to you via a share link after account verification.

What features in the Ponto 5 SuperPower will benefit my patients?

The Ponto 5 SuperPower has all the wonderful features of the Ponto 5 Mini, but with added MFO allowing a fit for hearing loss up to 65 dB HL BC. Ponto 5 SuperPower also offers OpenSound Navigator™ for 360o sound that provides proven better speech understanding in noise, OpenSound Optimizer™ for 5 dB more stable gain with less potential for feedback and is built on the Velox S™ platform. As a bonus, this most powerful sound processor also has low-energy Bluetooth® for direct connectivity to Apple® products and other connectivity.

What wireless accessories are compatible with the Ponto 5 SuperPower?

Our entire portfolio of wireless accessories that patients have come to rely on are compatible with the new Ponto 5 SuperPower, including the ConnectClip™, EduMic™, TV Adapter™ 3.0, and remote control. As with the Ponto 5 Mini, this new device is Made for iPhone® and has the ability to stream an audio signal directly to the iPhone. Our Oticon ON™ app is available for use for both iPhone and Android™ users.

Which app(s) can be used with the Ponto 5 SuperPower?

  • Oticon RemoteCare for remote programming sessions
  • ON can be used for controlling the Ponto 5 SuperPower using a compatible smartphone
  • Ponto Care™ app is great for support and guidance, but also to help patients develop good cleaning and maintenance habits with their softband, abutment or Ponto processor
  • Lastly, Oticon RemoteCare allows providers to perform adjustments to patient processor settings during telehealth visits

I have a patient who wants to upgrade from the Ponto 3 SuperPower. Where do I start?

That is a great question! It is actually a very simple process. There are two insurance forms that need to be completed and returned to the Insurance Services Department at Oticon Medical: a Patient Insurance Form and an ENT Insurance Form.

  1. The patient will complete and return the Patient Insurance Form to Oticon Medical Insurance Services Department along with a copy of their insurance card.
  2. The audiologist and ENT will complete the other form, the ENT Insurance Form and return it to Insurance Services along with these documents:
  • A signed prescription for the ordered upgrade (must be signed by a physician)
  • Medical notes (should be within the last year)
  • Latest copy of audiogram (should be within the last year)
  • Processor and Accessory Order Form

The items can be returned to our Insurance Services Department via email at insuranceservices@oticonmedical.com or faxed to 888-683-8736. If you have any specific questions, our Insurance Services Department is happy to assist you by email or phone at 855-400-9761. They are available Monday-Friday, 8am-8pm EST.

Lastly, if you are wondering if the patient is eligible for an upgrade based on the age of their current Ponto processor, please contact Customer Service M-F 8am-8pm ET at 888-277-8014 (choose Option 1) or email anytime to info@oticonmedicalusa.com and they can quickly provide you with that information.

Is the Ponto 5 SuperPower MRI-safe?

No, the Ponto 5 SuperPower processor is not MRI-safe and should be removed prior to getting an MRI scan. However, the implant and abutment are MR-Conditional and may be subjected to a MR scan as long as following conditions are met:

  • Static magnetic field of 1.5 and 3 Tesla only
  • Maximum spatial field gradient of 3,000 gauss/cm (30 T/m)
  • Maximum MR system reported, whole body average specific absorption rate (SAR) of 4 W/kg in the first level controlled mode.

In non-clinical testing, the image artifact caused by the device extends approximately 10 mm from the Ponto Implant System when imaged with a gradient echo pulse sequence and a 3.0 Tesla MRI system.

What should I consider when fitting a pediatric patient with a Ponto 5 SuperPower?

You are off to a great start by considering fitting a pediatric patient with the Ponto 5 SuperPower. There are several benefits that you and your patient will appreciate, and we are excited to have an opportunity to touch base on a few of them:

  • High MFO, OpenSound Navigator & OpenSound Optimizer. The ideal choice to ensure audibility and output and headroom for the dynamic range of speech, sound processing technology that provides access to the full soundscape to support incidental learning, and advanced feedback management that prevents feedback without compromise, as it does not reduce gain.
  • Integrated battery door lock. There is no need to change out the battery door, because it has a locking mechanism right on the door that is intuitive to use and ensures the battery door is tamper-resistant to small fingers. Simply use the Multitool and turn the screw clockwise in the direction of the locked padlock icon to lock the battery drawer. To unlock the drawer, turn the screw counterclockwise in the direction of the unlocked padlock.
  • Excellent battery life with the 675 (CI) battery of approximately 54-120 hours.
  • Pediatric Preferences Settings. Directionality and noise reduction features based upon age of the child.
  • Age bracket notification. When a child comes back for follow-up, this makes it easy to identify if changes to the Pediatric Settings are due to be reviewed and adjusted.
  • Multiple pediatric Outcome Measures (ELF, CHILD, PEACH)
  • DSL-BC Pediatric Fitting Rationale. Found under Program Manager or set it as your fitting default under Preferences
  • LED Indicators for peace of mind (Start-up, Continuous, Program, and Volume Changes)
  • EduMic compatibility for school-friendly, easy-to-use FM connectivity or remote mic use
  • Parent-friendly Connectivity. Oticon ON App, direct-to-iPhone, Find My Processor, and  ConnectClip
  • Ponto 5 Softband. Coming soon! Anticipated for release in late summer 2022 (NOTE: implantation is contraindicated for patients up to 5 years of age)

Oticon Medical has a great resource for pediatrics. The Pediatric Fitting Guide is available on our website for download, or you can request hard copies for your clinic from your local Oticon Medical Clinical Specialist. ATS is available should you have any questions, or you would like fitting assistance.

I am fitting a Ponto 5 SuperPower for the first time, and I might need some assistance. Who can I call?

The Auditory Technical Support team is available and on standby to support you when you need it. You can reach us via email at audiologysupport@oticonmedical.com and by phone at 888-277-8014 (Option 4). Our hours are 8am-8pm EST.

About the authors

Gail Leininger, Au.D., CCC-A is an audiologist who has worked with implantable technologies for over twenty years. She is an Auditory Technical Specialist for Oticon Medical.

Nicole Maxam, Au.D. CCC-A is an Auditory Technical Specialist at Oticon Medical and joins the team with 17 years of experience as an audiologist.

Alicia Wooten, Au.D. CCC-A is a Senior Auditory Technical Specialist at Oticon Medical. She specializes in implantable hearing devices and has a strong passion for aural rehabilitation and its impact on patient outcomes.

Insurance and Bone Anchored Hearing Systems

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.

Presidential Perspective

3 Tips for Cultivating a Strong Network of Advocates

One of the things that most impressed me when I joined Oticon Medical-US was its devoted network of consumer advocates. These are people from all around the country, from many different walks of life, connected by our Ponto™ devices—either as wearers of our bone anchored hearing system or as parents/caregivers to child wearers. This has bonded them not only to one another, making them an extended “family,” but also to our company, to which they are extremely loyal and publicly supportive.

Marketing, PR, and advertising are all important to a business’s success. But bottom line, you simply cannot duplicate the kind of goodwill, virality, and corporate confidence produced by a strong network of consumer advocates. So how can you cultivate yours? Here are three tips that have certainly worked well for us.

1.  Communicate with consumers throughout the sales process—and beyond

One of the simplest, and yet often ignored, methods for engendering consumer loyalty is clear and consistent communication. This must begin from the consumer’s entry into the sales funnel through their conversion into a customer, and then continue for as long as they remain a customer. This can be as simple as scheduling regular emails informing consumers about upcoming product releases, events, and other corporate goings-on of interest. You can increase or decrease these scheduled emails based on analytics showing open rates, click-throughs, and unsubscribes—if too many emails are being ignored or causing people to unsubscribe, then reduce the cadence. A/B testing can also help you determine which subject lines and matter garner the most interest, so you can refine your email content over time.

Additional points of contact should include company-run forums, in which consumers can ask questions or present concerns. We have a community called Oticon Medical Friends that is open to our Ponto wearers and caregivers to wearers, along with two Facebook Groups, one for all wearers and one exclusively for our advocates.

And it goes without saying that you should make it easy for consumers to contact you via email, telephone, direct message, or online chat—and when they avail themselves, someone at the business should answer them immediately, or at least within 24 hours during the work week. For when no one is available (over the weekend or during holidays) set up automated responses, so that consumers receive acknowledgement and have their expectations set as to when they will receive a response.

2.  Provide customer service that exceeds expectations

There is a reason customer service is considered a “frontline” position. They are your business’s spokespeople, and it is by their words and deeds your company will be judged. Empower your customer service team to not only meet the basic expectations of being polite, friendly, and helpful, but by going above and beyond. Little extras like shipping for next-day delivery so a person doesn’t have to wait on a necessity go a long way toward building loyalty. So does tracking down a solution for an issue that may require work beyond the initial contact. Customer service reps should regularly inform the waiting consumer of the concrete steps being taken on their behalf. Maybe throw in a little extra like free batteries, or a spare part along with the item ordered. Remember that old shampoo commercial, where “They’ll tell two friends, and they’ll tell two friends, and so on…?” That certainly holds true for recipients of excellent customer service.

3.  Show your passionate consumers lots of love

Loyalty to a brand or business should be appreciated—loudly, and as frequently as possible. How do you do this? By putting together an advocacy program that encourages the bringing aboard of new advocates while rewarding the old. A strong advocacy program should include events, such as meetings to introduce newer advocates to your company’s leadership team and other advocates. Provide them with “insider” information on upcoming product releases and actively solicit their input for future development of new products and features.  You can recognize your top advocates with an annual award or by creating an upper tier for all advocates to strive toward. In our case, we have Ambassadors, who are our top advocates, and they receive perks such as their own special event annually.

The bottom line…

Yes, these efforts require investments of time and money. They also yield the kind of loyalty and devotion most brands only dream of having and enable you to extend your reach well beyond typical sales and marketing efforts.

Evaluating Benefit and Monitoring Progress in Young Children with a Bone Conduction Hearing Device

Providing early access to sound is critical for children with prelingual hearing loss to develop speech and language skills on par with their typical hearing peers (Sininger, Grimes, and Christensen 2010; Bagatto et al. 2011, 2016; Tomblin et al. 2015). Evidence-based prescriptive formulae, such as DSL v 5.0 and NAL-NL2, are available in hearing aid fitting software and real-ear verification measures when fitting air conduction hearing aids to infants and children who have hearing loss (Scollie et al. 2005; Keidser et al. 2012).

However, strategies for fitting a bone conduction hearing device (BCHD) to a young child is lacking.  Additionally, the use of a consistent protocol within pediatric clinics for children with a BCHD has not been well defined.  In fact, a survey completed by Gordy and Bagatto (2020) found that audiologists are seeking guidance on how to provide optimal amplification to children who use BCHDs, and the aided audiogram is the only consistent measure used to verify BCHD fittings.

Given the limited availability of clinical tools, such as a skull simulator and prescriptive targets, audiologists need to consider other subjective test measures to use when fitting young children that are readily available in most pediatric audiology clinics.  These include, but are not limited to, parent report measures (e.g., The Auditory Skills Checklist, LittleEARs,) the Ling Six Sound Test, closed-set and open-set speech perception test measures, as well as standardized speech and language assessment measures.

As a leading manufacturer of bone anchored hearing solutions, we felt compelled to develop a suggested assessment protocol for monitoring the auditory skills of children ages three-to-five years fit with the Ponto bone anchored hearing system. This blog provides an overview of a straightforward assessment process that clinicians can incorporate into their fitting and management of young children with a BCHD.

Leveraging the Pediatric Minimum Speech Test Battery (PMSTB) developed by Kristin Uhler and colleagues in 2017, we created a streamlined assessment protocol for audiologists to consider when fitting young children with a BCHD.  This protocol is purely based on subjective assessment measures and a way for clinics to establish consistency among audiologists.  Beginning by verifying that a young child can detect the Ling Six Sounds, an audiologist would move to a closed-set speech perception test measure designed to evaluate a child’s pattern perception abilities and word identification skills.  Assuming the child demonstrated consistent word identification we suggest evaluating how the child responds to recorded open-set word and sentence recognition test measures. Finally, we recommend using a parent report measure to end the evaluation.

The protocol consists of a laminated card outlining the straightforward steps to evaluating benefit using a combination of speech perception measures, a parent report measure, and aided soundfield testing. The protocol provides guidance on the test administration, including suggested test level in dBA and calibration of the audiometric equipment.  A suggested test measures flow chart is provided along with a record sheet to document the child’s results. The protocol is recommended for all BCHD indications for a child ages three-to-five years.

Until a standardized objective verification protocol using a skull simulator with prescriptive targets is developed for young children, we would encourage clinicians to consider using this protocol or something similar to monitor a young child’s auditory development with a BCHD.

To learn more about this protocol, we encourage you to reach out to your regional clinical specialist 

About the Author

Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for 29 years. She is presently the Training Manager for Oticon Medical.

References

1. Bagatto, M. P., S. T. Moodie, R. C. Seewald, D. J. Bartlett, and S. D. Scollie. 2011. “A Critical Review of Audiological Outcome Measures for Infants and Children.” Trends in Amplification 15 (1): 23–33. doi:10.1177/1084713811412056.
2. Bagatto, M., S. Moodie, A. Malandrino, C. Brown, F. Richert, D. Clench, and S. Scollie. 2016. “Prescribing and Verifying Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Protocols and Outcomes from the Ontario Infant Hearing Program.” Journal of the American Academy of Audiology 27 (3): 188–203. doi:10.3766/jaaa.15051.
3. Dave Gordey & Marlene Bagatto (2020): Fitting bone conduction hearing devices to children: audiological practices and challenges, International Journal of Audiology, DOI: 10.1080/14992027.2020.1814970
4. Keidser, G., H. Dillon, L. Carter, and A. O’Brien. 2012. “NAL-NL2 Empirical Adjustments.” Trends in Amplification 16 (4): 211–223. doi:10.1177/1084713812468511.
5. Scollie, S., Seewald, R., Cornelisse, L., Moodie, S., Bagatto, M., Laurnagaray, D., … & Pumford, J. 2005. The desired sensation level multistage input/output algorithm. Trends in Amplification, 9 (4): 159–197.
6. Sininger, Y. S., A. Grimes, and E. Christensen. 2010. “Auditory Development in Early Amplified Children: Factors Influencing Auditory-Based Communication Outcomes in Children with Hearing Loss.” Ear and Hearing 31 (2): 166–185. doi:10.1097/AUD.0b013e3181c8e7b6.
7. Tomblin, J. B., E. A. Walker, R. W. McCreery, R. M. Arenas, M. Harrison, and M. P. Moeller. 2015. “Outcomes of Children with Hearing Loss: Data Collection and Methods.” Ear and Hearing 36 (01): 14S–23S. doi:10.1097/AUD.0000000000000212.
8. Uhler, K., Warner-Czyz, A., Gifford, R. and PMSTB Working Groups. 2017. “Pediatric Minimum Speech Test Battery” J Am Acad Audiol 28:232–247. DOI: 10.3766/jaaa.15123