A Day in the Life of an Independent Audiologist.

Small businesses are experiencing many challenges these days: Covid concerns, marketing, overhead, insurance, finding good help, and many more. My clinic and staff at Hears to U, Audiology also have to contend with issues around being an agency designed to provide healthcare; in our case hearing healthcare. Things like dealing with governmental rules and regulations, insurance companies, suppliers, staffing, and yes, on occasion, patients.

Do people understand Health Care?

People can be a puzzle when it comes to their own health. Some feel they are fine, stay healthy through benign neglect, while others see their Primary Care Provider on a monthly basis (whether they need to or not). A few will take a more reasoned approach: see their PCP once a year or as directed, get their annual immunizations, get their tests done as scheduled, and address issues as they arise. If something begins to hurt, they go get it checked out. If they can’t see as well as they used to, again, they go get it checked out.

Audiology is a different duck.

At Hears to U, Audiology, we have had patients who have waited for years, sometimes a decade or more, before having a decrease in their hearing checked out. Why the wait? The reasons are as varied as the patients who took their time: some thought it would get better; others that it was a temporary situation; a few changed their lives to fit their hearing loss; some feel they will look old with a hearing aid and so the stigma is too much for them; still fewer opted to ignore it until their family members nagged them into seeing someone. A few patients feel that hearing loss is a problem for “old people”, and they were too young to wear a hearing aid (forgetting about the toddlers out there who wear one). And sometimes money is truly an issue. Others just don’t want to spend their money on hearing aids; feeling health insurance ought to cover something like this. Shouldn’t they?

So besides all the other business issues, audiologists have a large knowledge gap to address.

A large segment of the population simply does not know about the potential side effects of an undiagnosed hearing loss: the changes that can occur within the brain, depression, social isolation, and a greater risk of developing dementia, to name but a few. How do you get the word out that hearing loss can lead to significant consequences if left untreated?

We have very smart patients at Hears to U, Audiology.

A few know these things, but a number have just made the decision to address the problem. The journey TO our door is less important than the journey AFTER you enter; except for the parts that affect your ears.

So, they come to see us, get a hearing test, learn that hearing aids would be beneficial, and then new obstacles come to light. Medicare does not cover the cost of hearing aids. Most insurance companies do not either. Many insurance companies work with hearing aid manufacturers to offer a hearing “benefit”. That alone raises red flags.

It is true that most of these benefits are actually third-party administrators that offer a discount to help keep costs low. What the consumer doesn’t know is that these third-party administrators are often owned by the manufacturer and/or the insurance company themselves. These discounts are not really an “insurance benefit”. It says so right at the bottom of their website.

The Consumer decides to GO with the assumed “insurance benefit”.

Many people, who we may or may not see at first, go to the network that was referred to them by their Medicare supplement or advantage plan like UCARE, UnitedHealthCare, Medica, Humana, etc. and are then referred to TruHearing (owned by Sivantos hearing) or UnitedHearing (formally Epic owned by Sonova Hearing, now owned by UnitedHealth Care and some sort of relationship with Sonova). And the consumer/patient is totally confused.

At Hears to U, we sometimes see the patient as they have been given confusing information because yes we are in-network with UCARE, UHC, Medica, Humana; BUT we are not in the third-party groups and it takes 20 or more minutes for us to explain what the heck! Sometimes it gets so confusing that the patient is told they have a benefit with us and months later after fighting for the money, the patient is then told they have to go to the third-party administrator to get the benefit. And sadly, it is too late for them to return the hearing aid they got and love from us.

The patient that does go to the network learns that they can choose between two pairs of aids. Two! Those are the two that are pushed. But wait, you can pay more if you want, which comes back to the price tag we offer at independent clinics, (not owned by the insurance company or the hearing aid company) and thus no benefit or discount at all.

There are dozens of different makes and models of hearing aids, each with its own sound and levels of technology. You may try to learn more from your insurance company; you call, but getting a straight answer can be difficult. You must go to the provider they tell you to go to. You may have to travel far. Or maybe there is one nearby, but in either case, you know nothing about this provider.

So, you decide on one of the pairs of aids offered to you. Are you told the price of the various choices in advance? You make a decision to buy. You purchase them, you walk away with them, you are happy, and then six months later something happens. You go back and find out that you will have to pay a service fee. Is that OK? Maybe you say yes; people should get paid when they are providing a service. Agreed. Were you told in advance what that fee would be? Are they able to do the work? Do you have to go somewhere else?

Or perhaps you walk away with your new pair, and within a few weeks, they are not working as well. They are not staying in your ear. Your ear now hurts. You go back to the store, and they are not able to help you. All they do is fit the aids for you. They cannot make adjustments. Now your $2000 pair of hearing aids (maybe even more expensive than that), are now sitting in a drawer, and you are back where you started. You are back to not being able to hear, you are not happy about it, and do not want to repeat the process. Completely understandable feelings. We usually see these patients and hear their stories.

The point of view of these networks from a Provider:

The provider is asked to sign a legal document that forbids them from sharing various points with the consumer. The provider gets paid a small service fee at the end of the “free” service to make sure the hearing aid is fit and the consumer knows how to use it. There is no need for best practices because there is no time and the provider in this network feels it doesn’t pay. The contract is convoluted and unethical in our opinion. That is why Hears to U, Audiology is not in these networks and other audiologists have chosen to rise above this type of deceptive practice.

Now let me tell you how different things are at Hears to U, Audiology. We are more of an odd duck than most! 😊

First, all our prices are on the clinic website, so you know precisely how much things will cost. We unbundle (charge services separately) or bundle services together in a little package to make things more affordable. We offer “demo” hearing aids, so you can try out different makes and models of hearing aids. This allows you to pick the one that most meets your needs. We work with most insurance companies, offer competitive pricing, and have payment plans available. We do not believe in supporting these third part administrators. We welcome people who purchased wrong to come to our clinic. We hope there is a clinic near you that is as transparent as us.

Stay tuned as we are going to talk about our new start-up to help those of you who are not in Minnesota and can’t come to see us.

Happy Hearing!