HearUSA Hearing Care Network

Frequently Asked Questions

1. Can I choose to participate in some plans but not others?
2. Can I participate in the network where there are company owned HearUSA centers?
3. How do I obtain reimbursement for services that I perform?
4. How long will it take for me to receive payment?
5. What should I do if I have not received payment on a claim more than 60 days ago?
6. Are there any fees to join the network?
7. What are the criteria for joining the network?
8. Which hearing aid brands participate in your programs?
9. Why are the prices so different for every plan?
10. Do I have to do free testing?
11. What happens if I move my office?
12. Can I be reimbursed directly to my bank?
13. How do I obtain an Explanation of Benefits (EOB) for the payments?
14. Why is HearUSA the middle man between providers and the plans?

1. Can I choose to participate in some plans but not others?
   • We need full participation for all accounts so that we can market accordingly and present a robust network.
2. Can I participate in the network where there are company owned HearUSA centers?
   • For the insurance network, there may be certain restrictions and certain panels may be closed.
3. How do I obtain reimbursement for services that I perform?
   • Because HearUSA sponsors many different types of plans, please refer to the current version of the plan design. Each plan has instructions regarding services and reimbursement.
   • Some plans have insurance payments, some require special authorizations, some are member discount programs, and some have restricted products or other limitations.
4. How long will it take for me to receive payment?
   • Reimbursement depends on the plan type. Sometimes we have to await payment from the insurance plan. This could take 30-45 days. In some cases, we have to wait for the member’s return period to expire, and this can also take 45 days.
5. What should I do if I have not received payment on a claim more than 60 days ago?
   • Contact us at providerrelations@hearusa.com to make sure the claim was received and that all required information is on file.
6. Are there any fees to join the network?
   • There are no membership or annual fees for participation.
7. What are the criteria for joining the network?
   • Licensed audiologist or hearing aid dispenser
   • Permanent office location with hours posted
   • Malpractice insurance coverage
   • No licensing violations, exclusions or sanctions from state or federal programs
   • Compliance with state licensing regulations (equipment, etc.)
   • Completed application and signed agreement
   • Compliance with program rules and guidelines
   • Approval by the credentialing committee
8. Which hearing aid brands participate in your programs?
   • All major brands are available.
9. Why are the prices so different for every plan?
   • We make every effort to obtain fair and generous reimbursement levels for our providers. Sometimes the plan mandates certain prices and some plans are for Medicaid members and therefore restricted. Cost controls are important for third party payers, so we work with them to develop the most appropriate pricing structure, depending on the plan parameters.
10. Do I have to do free testing?
    • Audiology testing, which is the only testing covered by insurance companies and Medicare, is outside of the scope of most of our programs. (Check your plan design to confirm.) Medicare doesn’t cover testing for the purpose of hearing aids – if you feel audiology testing is necessary, you will need to discuss this with the member and obtain authorization to bill the insurance payer.
    • We offer members a free hearing screening – this is an important part of increasing awareness around hearing loss. Many locations offer free testing, and members will often decline an appointment if there is a charge for the initial visit. If you prefer not to accept appointments for the screenings, we can put your name at the bottom of the list and advise members that you aren’t willing to provide the screening. It’s important for members to know what to expect at the time of the appointment, and we can always refer them to another provider in your area.
11. What happens if I move my office?
    • Please contact HearUSA to have your phone, address, email or fax number updated. We need this information to schedule appointments and provide reimbursements. To update contact information, please email: credentialing@hearusa.com
12. Can I be reimbursed directly to my bank?
    • Yes, please complete an ACH form to have your reimbursement submitted directly to your bank.
13. How do I obtain an Explanation of Benefits (EOB) for the payments?
    • EOBs are emailed to the address indicated on your application. To update it, please email: credentialing@hearusa.com
14. Why is HearUSA the middle man between providers and the plans?
    • HearUSA performs many services on behalf of the plan for members and payers. Examples include:
      • Administer oversight of all provider credentialing to represent a standard and quality professional to the payer marketplace.
      • Market the value of high-quality hearing services and products to the paying members as well as to the general consumer, thereby eliminating new patient acquisition costs.
      • Contract and coordinate the inclusion of hearing care and hearing aids within health benefit plans and programs.
      • Develop and manage the provider network to create access to qualified providers and streamline benefits and reimbursement.
      • Coordinate benefits and eligibility verification on behalf of individual providers under specialty care contracts with payers.
      • Advise large payers, and other plans developing specialty care protocols, on the value of adding hearing to their plans. Represent the standardized clinical protocols that are adhered to by professionals within the hearing care industry
      • Educate administrators on the mental, physical and economic impact of untreated hearing loss.
      • Advocate with all involved constituents including payers, medical plans, hospitals, trade associations, policymakers and the government, etc., for the value of hearing care and hearing aids.
    • HearUSA spends millions of dollars to market provider practices across the country. We refer callers to your practice, and require compensation for the services that we provide.

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