Insurance Update: Health Care Partners

It has been a long and argues journey with many frustrations and questions, but as with all things worth fighting for, I am pleased to announce that we have finalized a new Agreement with Health Care Partners that will be effective next month!!

Changes to the Agreement include:

• Preferred Provider Status

• Adjustment to the reimbursement rates

• Billing style-specific codes for both commercial & MediCal (just like we do with LA-Care).

Our new Agreement establishes Sonus Hearing Care Professionals as HCP’s ONLY Preferred Provider for Audiology and Hearing Aids throughout their entire Los Angeles, Orange, and Riverside/San Bernardino County Networks for their Commercial, Point of Service, Medicare, Dual Enrollees, and MediCal lines of business!!

This means that whenever an authorization for Audiology and/or Hearing Aids is submitted by a Referring Provider through the HCP Portal, Sonus Locations for that Region will be either listed on top as Preferred Status or will be the only option available.

Through the Agreement we have established a Flat Rate for all of their members at which we will bill HCP for, and based on Technology Levels we can UPGRADE HCP members to any level as long as the signed upgrade waiver is on file as usual.

The negotiated rates for Hearing Aids that HCP will reimburse Sonus for are as follows and will be reflected on the quote sheets you will receive back from the IVF team:

• Basic Level;

• Monaural HAs: $1,800.00

• Binaural HAs: $3,500.00

We have also extended flat rate upgrade limits to the Silver and Gold Level technology as a discount for their members. The cost between the basic level reimbursement from HCP above and the upgrade amounts are the member’s responsibility to pay.

• Silver Level;

• Monaural HAs: $2,000.00

• Binaural HAs: $4,000.00

• Gold Level;

• Monaural HAs: $2,200.00

• Binaural HAs: $4,200.00

Platinum and VIA AI are charged to the member at the current retail rates and the member is responsible between that price and the Basic Level price listed above.

• Accessories are the member’s responsibility and charged at the normal retail amounts unless there is a medical necessity and is prior authorized by HCP.

NOTE: When billing HCP, we need to use the style-specific Commercial or MediCal codes. Please DO NOT use V5298 for HCP members.