Insurance support

If you need assistance navigating what can be viewed as a complex process, Cochlear Americas offers individual insurance support. For help getting started call Cochlear’s OMS Insurance Support at 1-800-633-4667 or visit www.omsinsurancesupport.org ,or email  reimbursement@cochlear.com.

The general process for obtaining insurance pre-authorization for a cochlear implant is usually simple. However, there are occasions where additional steps, such as an appeal, are required. The general process is detailed step-by-step below:

• Patient’s insurance information is collected.
• Healthcare provider will contact the insurance company to confirm benefits and obtain a fax number or address to send a predetermination letter request.
• Healthcare provider submits a predetermination letter explaining the procedure and includes the billing procedure codes and diagnosis. They may also include a letter of medical necessity from the physician, patient history notes, audiograms, CT scan results, etc.
• Healthcare provider/physician follows-up with the insurance company approximately 10 business days after submission to verify receipt and status of review.
• Healthcare provider/physician follows-up every week to ten days until a response is received.
• If a healthcare provider tells you that a denial is received, check to see what appeal options are available. If the denial letter does not specify the appeal options, check your health insurance benefit book.
• Work with your healthcare provider or a cochlear implant manufacturer for appeal until approved or until all appeal options are exhausted.