US Insurance Support
Once you have decided on a bone anchored solution you must determine and verify that your benefits cover a bone anchored solution. While this may seem daunting, Oticon Medical Insurance Support is here to make the process simple and easy for you and your hospital or clinic.
Oticon Medical Insurance Support will work with you to do everything from verification of benefits to submitting the paperwork to insurance providers to request and receive pre-authorization for the procedure. We do this in a confidential and private manner to protect your healthcare information at every step of the process. In the event that your request for pre-authorization is denied Oticon Medical Insurance Support will investigate the reasons for denial and help to formulate and submit the appeal.
Frequently Asked Questions
Many questions on insurance issues can arise prior to getting a bone anchored hearing system and below you will find the most frequently asked questions.
1. How do I contact Oticon Medical Insurance Support?
You can call the Oticon Medical Insurance Support staff at 1-888-277-8014, please ask to speak to a staff member in Insurance Support. If you need to fax anything in you can do so at the number listed below along with the address. Please be sure on all faxes to include your name and contact information and put it to the attention of Insurance Support.
580 Howard Avenue
Somerset, New Jersey 08873
2. How do I know if my insurance carrier covers the Oticon Medical Ponto System?
Your doctor’s office, Oticon Medical Insurance Support or yourself can contact your insurance provider and verify your benefits. When making a call to your insurance company there should be a phone number located on the back of your insurance card that will put you in touch with member services for your plan.
3. Will I have to have my insurance approval before I can be scheduled for surgery?
This is a decision for the hospital that you would have the surgical procedure at. You can speak with your surgeon’s office as they are most likely familiar with the hospital policy in these situations.
4. How do I go about receiving approval from my insurance provider?
Either your doctor’s office or the Oticon Medical Insurance Support staff can aid you in this process. This process begins with certain documents being filled out and signed. These documents can be obtained from either your doctor’s office or Oticon Medical. Once all of your paperwork is collected either your doctor’s office or Oticon Medical will contact your insurance company to begin the pre-authorization process. When the process is complete you will receive a call with the results of the pre-authorization process.
5. How long does the approval process take?
Most pre-authorization cases take between 4 to 6 weeks, although some case may take longer.
6. What options do I have if my insurance provider denies my request?
We encourage you to speak with either your doctor’s office or the Oticon Medical Insurance Support staff to see if an appeal would be an appropriate action for your case.
7. Does Medicare cover bone anchored hearing systems and/or new processors?
Medicare does cover bone anchored hearing solutions, including the surgery and the processor. Medicare also covers a new processor once a Medicare patient’s current processor has exceeded its useful life (a minimum of five years).
8. Can I get my Medicare covered replacement processor through Oticon Medical?
Yes, Oticon Medical is an accredited Medicare provider. This accreditation allows Oticon Medical to bill Medicare directly for replacement processors in you have qualifying Medicare coverage.
9. What if I am a Medicare patient, do I still need prior approval from Medicare?
You will need to speak with your doctor’s office or Oticon Medical Insurance Support to determine if prior authorization is necessary under your Medicare plan.
10. Does Medicaid cover bone anchored hearing systems?
We encourage you to speak with your doctor’s office or Oticon Medical Insurance Support to see if coverage is available under your state’s specific Medicaid program.
11. Is there a charge or a fee for the approval service from Oticon Medical?
There is never a fee for Oticon Medical Insurance Support.
12. If my insurance provider does not cover a replacement processor what are my options for paying out of pocket?
Patients have a few options where out of pocket payment is concerned; you can pay by credit card or by debit card. Unfortunately we are unable to take checks or COD orders. You may also be able to aquire financing through CareCredit, a company which specializes in financing for medical equipment. Visit www.carecredit.com or contact Oticon Medical Insurance Support staff and they can step you through the payment option you choose.
13. What is the difference between insurance support and payment options?
Insurance Support is aiding you through the process of determining coverage and gaining pre-authorization for your procedure. Payment options are for those instances where we determine that your insurance provider does not cover the cost of the procedure or a replacement processor and you need to pay out of pocket. If you have any questions about either please contact one of the Oticon Medical Insurance Support specialists.