Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions

Many of our Group Retiree Solutions plans now require all hearing aids supplied by their hearing vendor, Hearing Care Solutions (HCS). If you are not an HCS provider servicing a member, you must verify their out-of-network benefits. After verifying their benefits, if your patient has one of these plans, you should follow the information outlined in this document. If you are already an HCS provider, you will follow your existing processes.

Non-HCS providers serving members with hearing aid coverage administered by HCS must follow the protocol outlined below:

• All orders must be processed through HCS so that the member can use their hearing aid benefit.
• All hearing aid claims will be denied for orders not processed through HCS.
• Please submit all claims for the routine hearing exam directly to HCS for processing.
• Select Submit Referral for Out of Network Service at https://tinyurl.com/5n8kvusm.
• Complete all fields to enable HCS to verify eligibility information and issue a login to the provider website.
• Check your email for login instructions to the provider website.
• Proceed to the provider website to check eligibility and gain access to the list of hearing instruments available for your patient.
• Once you have recommended the patient’s hearing instrument(s), you can place your order on the provider website.
• HCS will review the order and contact the patient directly to collect any payment owed for the selected hearing instrument(s).
• Upon receipt of the applicable payment, HCS will submit authorization to deliver in the provider portal:
  • For BTE, RIC, Signia Silk Click, Active Pro, and Active Instruments, HCS will submit the order directly to the manufacturer and then ship it directly to your office for delivery to the patient.
  • For all custom instruments: HCS will upload the order form back to the provider website upon authorization, and you will be responsible for submitting the order directly to the manufacturer with the custom impressions. Please only submit custom instrument orders to the manufacturer once HCS has authorization.
• You may fit the patient upon receipt of the HCS authorization for delivery and the hearing instrument(s). Please only fit the patient with authorization from HCS.
• Please fit the patient within 30 days of receiving authorization from HCS. If you cannot fit the patient within 30 days of authorization, please promptly return the devices to the manufacturer and communicate the cancellation to HCS.
• HCS will send you a delivery receipt shortly after issuing authorization. This document must be completed, signed, and returned to HCS to pay your provider fee. Note: This is a required document for payment of your provider fee.
• Please ensure every patient signs a completed purchase agreement, as this is a state-mandated document. If you have yet to make one readily available, you may download the HCS purchase agreement on the provider website. This does not have to be transmitted back to HCS, but it should be provided to the patient, and you should retain a signed copy.
• If the patient is using Care Credit financing, you must also submit the signed Care Credit sales slip. HCS will transmit this to you before delivery for the patient to sign. Please note that this is a required document (when a patient uses Care Credit financing) to pay your provider fee.
• The member has a 60-day evaluation period to exchange or return the instruments. Please process all exchanges and returns through the provider website.
• HCS will ship a first-year battery supply directly to the patient following the completion of the evaluation period.
• Please submit the completed delivery receipt and Care Credit sales slip (if applicable) to HCS by way of email or fax.
• Payment for services will be remitted to you after completing the 60-day evaluation period and receipt of all required documentation (delivery receipt and Care Credit sales slip where applicable).

HCS provider support number, fax, and email are on all documents for easy reference:

• Support email: providerservices@hearingcaresolutions.com
• Support phone: 877-583-2842
• Document submission: faxorders@hearingcaresolutions.com or 888-456-3047

If you would like to become an HCS provider:

• Online application: https://hearingcaresolutions.com/provider-application
• Recruitment email: applications@hearingcaresolutions.com
• Recruitment phone: 303-407-6813
• General inquiries: https://hearingcaresolutions.com/provider-program-information