earVenture as an Insurance Solution for Your Practice

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Insurance has become a larger part of the hearing aid landscape. Many patients now have some form of insurance coverage or benefits. Unfortunately, many third-party carriers, including many state Medicaid programs, restrict the allowable amount that insurance will cover for the hearing aid itself. This can be an especially problematic situation if you bill hearing aid services to payers in a bundled manner.

earVenture offers a quality, entry-level solution for these types of situations. IntriCon, a global company which supplies products to a leading US insurer and the government of Great Britain, manufactures earVenture.

The earVenture devices offers the most important hearing aid features for enhanced patient performance and success: eight channels, noise suppression, feedback management, directional microphones and a telecoil.

The hearing aids can be dispensed as either a bundled service, where the items/services surrounding the hearing aid fitting are billed to the patient under a single code, or unbundled service, where the items/services surrounding a hearing aid fitting are billed to the patient individually, using separate codes.

Bundled billing can be useful in situations where the payer takes a discount off of billed charges or where the fixed benefit amount is inclusive of hearing aids and all of their related services. Unbundled billing is useful when the payment is based upon a fixed allowable amount for the hearing aid and all related services are paid as separate codes. Third-party payers, with the exception of Medicaid, typically do not cover long-term care of the hearing aid. Their hearing aid coverage and benefits are typically exhausted at the fitting. Long-term service in an unbundled model would typically become the financial responsibility of the patient.

Description of Service CPT or HCPCS Code
Bundled
Hearing Aid V5257 (monaural) or V5261 (binaural)
V5264 (custom earmold) or V5265 (dome) Earmold/insert
Unbundled Audiometry for a hearing aid S0618 or 92557
Hearing Aid V5257 (monaural) or V5261 (binaural)
Earmold/insert V5264 (custom earmold) or V5265 (dome)
Hearing aid examination and selection 92590 (monaural), 92591 (binaural) or V5010
Electroacoustic analysis, if provided 92594 (monaural) or 92595 (binaural)
Dispensing fee V5241 (monaural) or V5160 (binaural)
Hearing aid fitting and orientation V5011
Verification, if provided V5020
Batteries V5266 times number of batteries provided
Accessories, if provided V5267 with each accessory as separate line items
Hearing aid follow-up within evaluation and adjustment period 92592 (monaural), 92593 (binaural) or V5011
Hearing aid follow-up/check visits once aids are accepted, or 92592 (monaural), 92593 (binaural) or V5011
Long-term service plan once aids are accepted V5299