Pax’s Ear Fund is a health care reimbursement program for audiologists. This fund helps reimburse audiologists for the fitting/programming fee for their patients who have microtia and aural atressia when insurance denies the code for this service, allowing audiologists to still be able to provide the gift of hearing.
While insurance providers may have a code for cochlear implant programming and the cleaning and programming of hearing aids, there may not be an equivalent billing code for the fitting/programming of bone conduction hearing devices. This can leave the patient having to pay out-of-pocket for this service when they often cannot afford to do so. When fitting and programming bone conduction hearing devices, audiologists may try to bill under the unlisted CPT code 92700 but may still be denied by the patient’s insurer. Ear Community can help! Pax’s Ear Fund would allow audiologists to seek direct reimbursement for these appointments. Reimbursement would be allowed for (1) fitting/programming fee per patient only and not to be used multiple times on the same patient. The reimbursement would go directly to the audiologist/audiology clinic from Ear Community for this service, not to the patient.
* Patients must have microtia and or aural atresia.
How audiologists can benefit from Pax’s Ear Fund:
1. Set up Ear Community as a vendor in the audiologist’s clinic system so that a billing invoice can be generated to Ear Community for the reimbursement request.
2. Requests for reimbursement must be approved by Ear Community first before billing our organization directly. This can be done via email along with verifying the cost of the (1) fitting/programming fee for the patient and simply having both parties agree to the reimbursement amount with date of service. Please send an email to Melissa at: EarCommunity@gmail.com
3. Please also email a copy of the denial letter from the insurer to Ear Community. Clinics may simply choose to send Ear Community a copy of the financial agreement form that informs the patient of the out-of-pocket cost in advance of the fitting/programming as proof for reimbursement request.
4. Email the completed form to Ear Community along with the insurance denial letter for the patient.
Ear Community Programming Reimbursement Form
Paxs Ear Fund details
5. Ear Community would mail a check directly to the audiology clinic for that audiologist to be reimbursed.
It is Ear Community’s goal to help as many children and adults to hear their best as much as possible. The reimbursement for audiologists for the patient fitting/programming will be on a first come first serve basis. Ear Community will respond with the acceptance of the reimbursement or let the audiology office know if our organization’s funds for the year have already been exhausted upon the audiology clinic reaching out before both parties enter agreement for reimbursement. Pax’s Ear Fund is made possible by a sweet little boy named Pax who was born with microtia and atresia. Pax and his family know how important it is to help provide the gift of hearing to those in need. Ear Community is grateful for Pax’s Ear Fund! Pax’s fund gives Ear Community the opportunity to help give back to the Deaf and Hard of Hearing Community when helping members of the microtia and atresia community thrive.
Thank you,
Ear Community
www.EarCommunity.org
