This foundational-level course is designed to provide audiologists who are new to cochlear implants information on how and what to bill for services related to Cochlear’s implantable hearing solutions. Information will include a discussion of insurance terminology used by insurers, an overview of coverage and payment for implanted hearing devices, as well as a discussion of medical policies that affect a patient’s access to implanted hearing devices. This course is designed to provide a foundation to begin to understand the complex and often changing environment of coverage and payment within the current healthcare system.
Course created on August 16, 2017
- After this course, participants will be able to identify the differences between public and private health insurers.
- After this course, participants will be able to identify which data elements (diagnosis codes, CPT codes, and modifiers) are required for billing and reimbursement.
- After this course, participants will be able to contrast implant guidelines for government (Medicare and Medicaid) and non-government (commercial insurance companies) payers.
- After this course, participants will be able to identify important terminology pertaining to health insurance so they can better navigate the complexities of coverage and payment.
|10-30 Minutes||Insurance Terminology|
|30-35 Minutes||Basic Coding Concepts|
|35-50 Minutes||Commonly Billed CPT Codes, Modifiers and Edits|
|50-60 Minutes||Cochlear Implant Coverage and Addressing Denials|
Joan Sunderland, MBA
Senior Regional Reimbursement Manager
Ms. Sunderland is Senior Regional Reimbursement Manager at Cochlear Americas. In that capacity, she works with providers and facilities to engage payers (commercial, state, and federal) and various stakeholders to develop and implement strategies and programs that lead to increased acceptance and adoption of solutions for adults and children with profound hearing loss. Ms. Sunderland has worked on coding, coverage and reimbursement in the medical device industry with varied companies for over twenty years, including devices in the orthopedic, spine, cardiac, and biologic markets. Before joining Cochlear Americas, Ms. Sunderland was a consultant designing and executing strategic and tactical programs leading to expanded coverage (public and private). Ms. Sunderland holds a Bachelor of Science degree from the University of Oregon, as well as an MBA from Willamette University.
Ms. Hupp is a Reimbursement Manager at Cochlear Americas. Ms. Hupp leads the OMS Insurance Support team which provides support to candidates and healthcare providers seeking to obtain necessary insurance approval and to support appeals where coverage has been denied for Cochlear’s Nucleus® Cochlear Implants or Baha® Systems for medically qualified candidates. Ms. Hupp has an in depth understanding and proven experience in navigation of the reimbursement landscape to assist customers in obtaining positive coverage and ensuring access to implantable hearing devices. Prior to joining Cochlear Americas, Ms. Hupp held multiple roles within United Healthcare’s Medical Management department, including medical claims review, provider and member appeals, and prior authorization. Ms. Hupp holds a Bachelor of Science degree from Colorado State University
Susan Hupp: Financial: Susan Hupp is employed by Cochlear Americas. Non-financial: Susan Hupp has no non-financial relationships to disclose.
Sponsor Disclosure: This Course is presented by Cochlear Americas in partnership with AudiologyOnline.
Content Disclosure: This learning event focuses on Cochlear Americas products and services and will not include info on other products or services.
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