Episode 19 Top Ten Questions for Audiologists

The Transcript

Dale Johnson: The conversation starts here four days before Christmas. Merry Christmas to you and yours from KFOR FM 103.3 1240 AM and from the good folks at Complete Hearing. complete-hearing.com Merry Christmas.

Dr. Miller: Same to you. Merry Christmas. I just don’t think I know how much talking I’m going to be doing today because as I sat down at the microphone today, there’s two pastries in front of me.

Dale Johnson: I surprised Dr. Miller with a treat.

Dr. Miller: Yeah, so if your listeners don’t hear anything from me, it’s probably because I’m eating.

Dale Johnson: We have good people around us who bring us good treats.

Dr. Miller: I love it.

Dale Johnson: Before the holidays so I thought I’d share them. You get asked a lot of questions.

Dr. Miller: We do get asked a lot of questions.

Dale Johnson: We have David Letterman’s top 10 list of questions. Let’s go with number 10 and then we’ll work our way up.

Dr. Miller: I don’t know if I put these in order, but let’s just do it anyway.

Dale Johnson: Okay. Why don’t you do free hearing tests, Dr. Miller?

Dr. Miller: That’s such a good question. We get that a lot when people hear about I can get a free hearing test here or why don’t you do that at your office? We participate with Medicare and many insurance companies and when you participate with Medicare you have to treat every single patient the same and offering services for free is not something they allow and so we do free hearing screenings. A screening is like a pass-fail test. We’ll play a sound for you at say 2025 decibels atone at each individual pitch and tell you whether you responded or didn’t respond. That’s a screening which we can do for free. What we cannot do for free is a hearing test to find out exactly at each pitch what your level of hearing is and we are obligated by that by being participating with Medicare.

Dr. Miller: So, that is the reason we don’t do them in our office. We cannot. We are not allowed by insurance regulations and because we participate with Medicare. So if you are going to get a free hearing test somewhere, more than likely they’re not submitting that to any place in terms of an insurance benefit and more than likely they are actually tying that cost into more of the hearing aid itself.

Dale Johnson: Alright, so let’s go from Medicare into an insurance question. Does insurance cover the hearing tests?

Dr. Miller: Such a good question. Most insurance companies will cover a hearing test. Medicare will actually cover one hearing test per year if it’s medically necessary. What does that mean? That means you have to have some symptoms that are showing its necessary for you to have your hearing tested. Many people don’t realize that it’s a covered benefit and so yes, your insurance company will cover the hearing test.

Dr. Miller: Now imagine that some people have deductibles or they have co-insurance or they have things they still have to meet out of pocket, but we do file with insurance through our office. So yes, we can have it covered by the insurance company.

Dale Johnson: You wore headphones a couple of shows ago.

Dr. Miller: I did.

Dale Johnson: And do you think that I would have reason to get a hearing test?

Dr. Miller: Well, my goodness, if you tuned in the last time we were with Dale, I put the headphones on. He said, “Well, this is where I have to listen to my voice so I can hear myself.” And I thought, Oh my goodness, this man needs to come and see me.

Dale Johnson: I like it loud.

Dr. Miller: So we should make sure that you get in eventually. Make that of your new year’s resolution is what I would tell you.

Dale Johnson: I’ll come in and 2020.

Dr. Miller: Awesome.

Dale Johnson: Does insurance cover hearing aids?

Dr. Miller: That’s a really great question as well. We have some insurance companies actually who do cover hearing aids and then what we typically find is it’s written into the benefit policy of maybe where you work. So we might find that you have a certain dollar benefit based on your insurance coverage. It has to be written into the policy. Just because you have United Healthcare or Blue Cross Blue Shield doesn’t mean you necessarily have a benefit. It’s what’s written into the policy. I kind of call it an addendum or a floater or an addition. That just means it’s written into the policy as an extra, which is nice. Some of our Medicare plans currently are coming out with benefits as well. We just want to make sure we educate our patients on what those benefits are and what they mean.

Dr. Miller: If you are a Medicaid recipient Medicaid covers hearing aids top to bottom, which is pretty nice too, so that’s in our state. So there’s many ways to go about hearing aid coverage. I would tell you it’s not as common as you would think. We used to say it was 5%. It’s becoming more common but it’s navigating through that whole insurance process that’s the challenge. And it’s confusing on our side so imagine how confusing it is on the patient side. So we try to help you navigate through that insurance question. Whenever you come to see us we will always check your insurance card and we will always call the provider for benefit to make sure do you have some benefits that we can utilize.

Dale Johnson: From a previous conversation I want to make sure I’m right here with the technicality difference between hearing aid and hearing amplifier.

Dr. Miller: Oh, back to that conversation.

Dale Johnson: Would insurance drop the insurance question.

Dr. Miller: Yes. An amplifier is just a general thing you could buy over the counter.

Dale Johnson: You can buy it on Amazon.

Dr. Miller: You can buy it on Amazon remember. All those great deals we were going to get online. Typically, what’s going to be defined in an insurance policy is going to be a true hearing aid and so it would have to be defined that way. We have these things called CPT codes. They are codes that identify exactly what the device is and how it’s identified and that’s how we bill the insurance company for the hearing aid.

Dale Johnson: So a complete hearing aid is much, much, much, much more than a hearing amplifier.

Dr. Miller: Well for sure.

Dale Johnson:
Obviously you can get it on Amazon that’s so much less than what you can get from a professional at Complete Hearing.

Dr. Miller: Exactly.

Dale Johnson: Do hearing aids, use the term aids not amplifiers. Do hearing aids really help ringing in my ears?

Dr. Miller: That’s such a good question. My patients are often surprised that we tell them that if they have hearing loss and they have ringing amplification is one of the ways to help the ringing. The analogy definitely is that we can never close our ears and so the brain always wants a certain amount of information and when you don’t get it, then sometimes you get tinnitus or ringing in the ears. And I would tell you 80 to 90% of our patients come back and will say, “Wow, this device has helped me so much.” Now it doesn’t necessarily make the ringing go away, but it will definitely help those day to day situations where it won’t be as distracting.

Dale Johnson: Dr. Sandra Miller from Complete Hearing. We’re reviewing 2019 with some very important questions that you have asked over the course of the year and years. Why do hearing aids cost so much?

Dr. Miller: Oh, I love this question so much, especially when we start talking about technology. My patients often will ask me, well your hearing aids they start for a hearing aid at $1,200. I can buy a hearing aid online over the TV in this magazine for hundreds of dollars instead of thousands of dollars. Why is there such a difference? We kind of talked about this already. It goes back to it being simply an amplifier. Those pieces that you’re buying, you get what you pay for when it comes to anything that’s going to enhance your hearing. When we talk about why hearing aids cost so much, I would tell you it’s the technology that goes into them. They spend millions of dollars in research and development to try to figure out how to deliver the best sound quality they possibly can. And if you were to ever visit a hearing aid manufacturer and see from where it starts, to how it’s developed, to what goes into that teeny tiny little thing that goes into your ear and how it’s honestly a computer in your ear, you think about the technology that goes into that is amazing.

Dr. Miller: I often would tell you I would agree. I think hearing aids are expensive, but boy, when you look at the technology that goes into it, it is amazing and they’re constantly doing research to make it better. And that’s always a great thing too. And it’s very high end technology driven and you just find the things that hearing devices can now do today that they couldn’t do before is pretty amazing.

Dale Johnson: I’m a simple guy so I will say hearing aids are like shoes, you get what you pay for.

Dr. Miller: That is so true.

Dale Johnson: For years, I bought cheap shoes and I would buy them every year because they were cheap shoes.

Dr. Miller: Exactly.

Dale Johnson: And then my wife got me to buy a really nice pair of expensive shoes and I love them and wore them for years. So hearing aids are like shoes.

Dr. Miller: Hearing aids are like shoes. I haven’t heard that comparison but we’ll take it.

Dale Johnson: You get what you pay for.

Dr. Miller: You get what you pay for.

Dale Johnson: Could I try hearing aids before I buy them?

Dr. Miller: We think about the investment that you’re going to make in technology and in our office we have something called an out of office demo program. So if you come into the office and we identify that you need some help, we’re always going to put something on you in the office and then give you the opportunity to take it out and test drive it. My office is a very quiet environment and that’s not where you spend your typical day. You’re going to be in the car, at the grocery store, at a restaurant with your family. We need you to experience this in the real world. And so yes, we let our patients test drive before they do any type of commitment. It really helps people who are kind of on the fence to say, “Oh my gosh.” And I would tell you the majority of people who come back say, “I cannot believe what I didn’t hear.”

Dale Johnson: I can’t believe what I couldn’t hear.

Dr. Miller: I can’t believe what I couldn’t hear.

Dale Johnson: Because it’s so gradual.

Dr. Miller: It is so gradual.

Dale Johnson: Can I return them if I don’t like them?

Dr. Miller: I’m going to encourage your listeners that if they buy a device anywhere that it is required by law that there is a return policy. So by the state regulations it’s 30 days. At Complete Hearing we give you 45 days. But yes, make sure that if you’re not satisfied that the devices can be returned. Our goal is to find the right solution right away. But you may find over your experience of that satisfaction time, that there’s something not quite right. I sometimes have buyer’s regret when I buy something and I’m not sure. I bought these devices, but am I going to wear them every day? Am I committed to doing this? So yes, they’re returnable and make sure that any place that you were to buy these, that you are able to return them.

Dale Johnson: Is fit one of the reasons people come back?

Dr. Miller: For us I would typically tell you it’s going to be more of the fact of I’m not getting the benefit that I thought I would get from this or I’m not wearing these like I thought I would. I would prefer that you return them than have them be sitting in your drawer somewhere and wasted thousands of dollars on something you’re not wearing. So we want to make sure that you’re satisfied.

Dale Johnson: How is all the different technologies?

Dr. Miller: Oh, so different.

Dale Johnson: People’s hearing is different. Technology is different. How and why?

Dr. Miller: So a couple of things I tell my patients is they might come in and ask for a certain device or a certain product. Your success with the device is going to depend on three things. The degree of hearing loss you have, what your speech understanding is and your expectations.

Dr. Miller: If you come in and say, “My friend Joe bought XYZ hearing aid and he’s doing awesome. That’s the hearing aid I want.” That doesn’t mean that hearing aid is going to be successful for you. And so what we try to do is pinpoint not only what you need in terms of style, but technology is going to play a big role. Everybody’s lifestyle is different. How often are you out and about? How often are you in noise? What is your auditory processing even like? So what does your brain need? And that’s different for everybody. And so we sell a very wide range of products. And I would tell you it’s more for the fact that financially people can only be in a certain level. If everybody could afford the best of technology, I would put it on everybody because I truly believe in how it helps people hear better.

Dr. Miller:
You can only hear as well as a sound is delivered to your brain and whatever the signals given to your brain is what you have to work with. And if that signal is awesome you’re going to have a much better success at hearing well. So when we talk through technology, honestly we talk about situations. We talk about how much clarity can you receive, how fast is the hearing aid work, and then what environments does it do well in? And then we try to match that to what your lifestyle is and then we try to pick the most appropriate product for you.

Dale Johnson: So, that would go a long way toward answering the next question. How do I decide what is best for me? You mentioned the clarity, the fit, the evaluation that they’ve received to get this product.

Dr. Miller: And we even talk about nowadays technology is so cool that we have rechargeability and we have hearing aids that connect to your phone and connect to your TV and connect to… It’s so amazing what they’re able to do now in terms of technology.

Dr. Miller: So does everybody need that? I find some of my patients go, “Hey, I just want to put this on and wear it. I don’t really care about all these other gadgety things.” But sometimes we have to display the technology and maybe have you experience it and you’d be surprised at how many people go, “I didn’t think I would want that phone in my ear but that’s pretty amazing.” And so to experience it and have the opportunity to try it gives you a better chance to have an informed decision of what’s best for you.

Dale Johnson: And how does someone decide where to go? We’ve mentioned online, we’ve mentioned over the counter, we’ve mentioned specialty professionals such as Complete Hearing. How does someone settle, not settle on but decide where to go?

Dr. Miller: I think the biggest thing that when you’re looking for a healthcare provider in any situation, what I usually do is I look at a Google review because that’s what everybody does now.

Dr. Miller: And then also asking friends for referrals, asking your physician who they’re referring to is another good, solid place to go. But I would just tell you, when you go someplace, you have to feel that you’re well taken care of, that you trust who you’re working with and that ultimately they have your best interest in mind. You should never feel pressured. You should feel cared for.
Dale Johnson: Learn all about it at complete-hearing.com. Enjoy your pastries and have a Merry Christmas.

Dr. Miller: I’m going to eat them right up. Same to you.

Dale Johnson: And join us every Saturday for the conversation starts here.