Members are searching for affordable and accessible options and want to learn more about Relate hearing aids. We have designed 2 types of programs — Preferred and Complete — in 2022 to better meet patient needs and experiences. The design of our new Preferred program will deliver a simplified solution and help you treat more Medicare Advantage members who typically have a copay associated with their benefit, while the Complete program serves all other member types.
We want these programs to create quality care experiences and support your practice’s growth this year. You are encouraged to learn more about the different programs and how they work to set you up for success in 2022.
What is the difference between the Preferred Program and the Complete Program? The Preferred program has 4 technology tiers to choose from, emphasizing affordability and access to Relate private label products. This simplified program is geared toward value-focused members and will help further align with member expectations. The Complete program has 6 technology tiers to consider, emphasizing member choice and access to premium solutions. Fitting fees differ between the 2 plans — except for Relate Gold, which remains consistent between programs. Please review the 2022 fee schedule in the provider reference guide.
Can I choose to participate in only 1 program? No. UnitedHealthcare Hearing providers are expected to see all members. We will send members to clinics that provide great experiences to all their patients.
How will I know if the patient has a Preferred or Complete plan? A member’s plan is listed at the top of the referral letter sent to your practice and determines which type of program they are eligible to receive. This information is also visible within the “opportunity” if you are a portal user.
Am I allowed to recommend and fit Relate Silver in-person? Yes, you may recommend and fit Relate Silver to patients in person beginning Jan. 3, 2022. Our Right2You program will continue to offer direct delivery/virtual care for patients who request it.
Why is the dispensing fee of the Preferred Plan different than that of the Complete Program? The professional fees are slightly lower with the Preferred Plan because it offers a reduced product formulary and a lower price offering. We strive to provide the best possible affordability and value to our members with out-of-pocket copay amounts, enabling more members to obtain solutions from your practice.
A patient is entitled to testing, including air/bone/speech (92557), during an office visit. What if test results indicate that the patient needs more in-depth testing? Based on your professional opinion, if a patient requires more in-depth testing, you need to be sure the patient understands the reason for the additional tests. You may bill the patient's insurance plan with their consent. Please be sure to verify coverage through their health plan prior to testing.
Is there a provider fee if a patient doesn't show up for delivery after hearing aids arrive in my office? If the patient is not fit, there is no professional fee paid.
Do all hearing aids have a 3-year warranty, including Loss & Damage? Yes. All hearing aids have a 3-year warranty and include Loss & Damage (L&D).
We can now manage L&D replacements on our own bill to account for when a member does not have L&D coverage. How do I find out if there is coverage? Please call us at 855-523-9355 for assistance in verifying the member’s coverage before processing an L&D.
What is the provider fee if a patient loses hearing aid(s)? What if lost hearing aids have custom earmolds and require new impressions? If a patient does not have L&D coverage you may directly charge up to $300 per device, which includes replacement device cost, earmold where applicable and related services charges from your practice. If the patient has coverage for L&D, the professional fee from UnitedHealthcare Hearing would be $100 per device.
There is a professional fee for earmolds in 2022. Does UnitedHealthcare Hearing provide the impression material? We have updated our professional fees to include an additional amount for ear molds to help cover some of the costs incurred for the material. We do not provide impression material.
Will you utilize 2021 or 2022 benefits if my patient decides to exchange this year? Hearing aids authorized in 2021 will utilize 2021 benefits, regardless of if the exchange happens in 2022.
How do I submit my updated license and liability insurance?
You can submit your updated license and liability insurance in the provider portal.
When is the earliest I can send in my re-credentialing documents? Your re-credentialing documents need to be submitted no later than 60 days prior to your credentialing due date. You will receive monthly reminder notifications from both UnitedHealthcare Hearing and Gemini starting 150 days prior to your due date.