Thursday, July 19, 2012

What if hearing loss "hurt'?

I spoke to a Chiropractor friend of mine earlier this week. By 3:30 p.m., his office had already seen 56 patients. I can't imagine seeing 56 patients in one day! But that's a fairly normal day for this doctor. People come to him for relief from pain, among other things. After he adjusts them, they feel better, which is obviously the reason people continue to make their follow-up appointments.

Which got me thinking. What would people do if hearing loss was painful? I'm not talking about ear infections and the like. I'm talking about normal (physically) pain-free sensorineural hearing loss that plagues most people with hearing loss. If the treatment involved temporary relief from pain until the next time, would there be more adopters of treatment by way of hearing aids? I'm not saying I wish hearing loss hurt; what I'm saying is I think it would be easier to convince someone with a newly diagnosed hearing loss to take that next step towards amplification if they had a nagging, painful reminder of their ailment.

As an Audiologist, it is so incredibly frustrating to see a patient that needs hearing aids, knows they need hearing aids, but decides to not use amplification. It leaves me scratching my head, asking, "why did they even bother to get a test if they weren't going to accept help?!?" Which leads me back to my question of, "if it physically hurt them, would it have made a difference?" I think about patients of mine that have had hip and knee replacements and most say that what drove them to having it done was the excrutiating pain they felt, the activities it kept them from doing. In general, their quality of life suffered as a result of their ailment.

Yet, many people with hearing loss say they can 'get by' without hearing aids. They never stop to think what the consequences of not taking the next step to amplification will be. While they may be able to ignore their hearing loss because it doesn't physically hurt, few consider the consequences of untreated hearing loss. Studies have linked untreated hearing loss to:
  • fatigue
  • reduced job performance and earning potential
  • impaired memory and inability to learn new tasks
  • reduced alertness and increased risk to personal safety
  • depression
  • increased stress
  • avoidance or withdrawal from social situations
  • irritability
  • anger and negativism
  • social rejection and loneliness
  • diminished psychological and overall health
Hearing loss is not just an issue for the elderly and infirm. It happens to people of all ages. Those who have difficulty hearing can experience such distorted and incomplete communication that it seriously impacts their professional and personal lives, which can lead to isolation and withdrawal.

Tuesday, July 17, 2012

The trouble with "discount" plans

I got a call this morning from a representative for a 'discount' hearing aid plan we somehow got affiliated with because we accept the insurance plan they are affiliated with. This has become a pretty regular thing and ,while I don't always care for their policies and procedures, it seems to be the 'wave of the future' so I am doing my best to accept this trend in the industry.

This representative was very nice, telling me she had a patient she wanted to schedule for a hearing test and hearing aid consult. I got the patient's name, address, date of birth, and other necessary information I needed to schedule her appointment and then I asked the rep for the patient's type of insurance and their primary care doctor. She asked me why I needed that information and I explained that I would need to get an order from their physician so I could bill their insurance for the hearing test. To which she replied, "you will not be able to bill for the hearing test. The patient's contract states that they are entitled to a free hearing test and it is against our policy for you to bill for your test."

Excuse me?

You want me to test your patient for FREE?

No. My time is not free. My landlord requires I pay rent for my beautiful office, Georgia Power requires payment for their electrical services, the City of Pooler wants me to pay for water as well. You get my point? And the bigger issue? It is ILLEGAL for me to perform a hearing test at no charge for someone if I accept Medicare and bill (the government) for the same test.

And besides the illegal part, what other doctor's office do you go to where their services are free? Nowhere! Even for those individuals on Medicaid and such that don't have any out-of-pocket expenses for their healthcare, SOMEONE is paying for the care. Why would that be true in my office or any other Audiologist's office, for that matter? Hearing is one of your senses, a vital part of your life. Is it not worth the small investment to have a comprehensive evaluation to determine the status of your hearing? For those that have insurance, it typically only costs them their co-pay. For those without insurance, most offices will gladly negotiate a discount based on the fact that payment would be made immediately without the hassle of filing insurance.

Back to the representative for the discount company. I brought up the fact to her that, if the patient chooses to NOT pursue amplification through their plan, they have my test and have used my time to get said test and I''m left with nothing. To which she proceeded to tell me that 'their referrals are carefully counseled and screened and most have no problem going with the Audiologist's recommendation'. Which is complete hogwash. In most circumstances, I am the one that is left to explain the plan's details, NOT the company's representative. The individuals who call their insurance company to get the referral to the discount company have been so snowed into thinking that the plan gives them


savings and when they learn how much (little?) the discount really is and how, when you compare apples to apples, they'll actually end up with less service than if they'd gone through the Audiologist directly, many of them choose to continue to do without amplification. In their marketing and advertising materials, most of these discount plans make outrageous claims, such as "up to 40% off!" What patients don't realize is that their discount is off the MSRP (Manufacturer's Suggested Retail Price), not off the ASP (Average Selling Price) found in most private Audiologist's offices. You would be hard-pressed to find an Audiologist who is dispensing hearing aids at the MSRP! When I compare the prices of most discount plans and my office for the SAME EXACT HEARING AIDS, there *might* be a $200-$300 difference per hearing aid. Don't get me wrong, that's $400-$600, not little money. But when you compare the service package with the discount plan versus the independent Audiologist, you can see why it's worth paying a little more to work with the independent Audiologist.

You are, most importantly, supporting a local, (probably) small business. You are working directly with the Audiologist, not someone in a corporate call center who has no power whatsoever to negotiate a discount, perk, extra accessory, etc. The service included with most discount plans is either a fixed number of visits or a fixed amount of time (i.e. 3 visits, 1 year) When you buy directly through your Audiologist, you typically get service 'for the length of the initial warranty period' (which is 1-3 YEARS). Every office is different, of course, depending on their pricing structure. We have entertained many options over the years, and while I don't claim to have it all figured out, I feel like we give each individual patient what they need, whether it is a comprehensive service package or a reduced up-front cost and then allowing them to pay for supplies and visits down the road. These are options you will not get when you choose to circumvent your independent Audiologist to purchase through a 'discount' plan.

I suppose it's time to wrap up this ramble. But I'll leave you with this.

Most discount plans will pay Audiologists such as myself a fitting fee to fit the hearing aid(s) and for their time for the included visits. But all supplies and additional visits are not included. So before you look at the price the plan is offering and compare it to your local Audiologist's price, find out what is included for each and make your decision from there. Recently, I had a patient that paid $5800 for a pair of premium digital hearing aids through one of these discount companies. Had he bought them through us, he would've paid $6200 for the pair. With the discount plan, he got a year of follow-up included for cleanings and adjustments. Had he bought them through us, he would've gotten 3 years of follow-up service included as well as 12 (8-packs) of batteries. Because there would've been no middle man, he would've been fit about a week earlier than he was. And if he loses one or both of his hearing aids, this 'discount' plan will require him to pay $400 per ear as a loss and damage deductible to replace each aid. Through my office, it will cost him $300 per ear; we don't charge the additional $100 per ear the 'discount' plan does as an administrative fee. So despite the $400 difference up front, when you compare apples to apples, you can see the said 'discount' plan isn't really a discount at all.

All I ask is that before you take business away from your local business, take the time to educate yourself on the ins and outs of the plan. You may be surprised what you find out!