eSolutions & Managed Care

By Nicole Klutz, Au.D.

In our previous blog, we discussed what the new normal looks like as hearing care providers (HCPs) and patients start to enter the rebound phase of the COVID-19 pandemic. We spent time reviewing what the new hearing healthcare patient looks like from a digital perspective and ecosystem, as well as how their hearing journey has change based on their experiences over the past four months.

How do you meet your patients where they need you the most and continue providing quality hearing healthcare services to sustain not only their hearing journey but your business as well?

From new patients to existing patients, expectations and behaviors related to hearing healthcare, hearing aid service, maintenance and overall interaction with your clinic have changed as a result of COVID19. The question now is: How do you meet your patients where they need you the most and continue providing quality hearing healthcare services to sustain not only their hearing journey but your business as well?

Regardless of the how the patient calling your office found their way to you – either via direct insurance, Third Party Referral Networks (TPRNs) or as a private pay patient – most likely they all share the same questions and expectations around what it means to come back safely to your office. They may be weighing the pros and cons of their expectations regarding what an in-person appointment may be like. Or, they may be wondering how they take their healthcare completely digital and if your office offers options similar to other telemedicine appointments they may have already experienced.

So, do you?

Offering eSolutions to every patient

Before COVID-19 hit, many HCPs were still considering their options when it came to eAudiology and remote care for their patients. Based on the local geography, patient demographic and the clinic’s service offerings, some HCPs and clinics were early adopters of eSolutions, like Remote Support, while others did not have a demand for such technology yet. While this may still be the case, the adoption of remote fitting services has increased simply due to mandated stay-at-home orders and need to stay in touch with patients, as well as provide them hearing services to ensure they are getting the best possible outcomes during this pandemic.

…the adoption of remote fitting services has increased simply due to mandated stay-at-home orders and need to stay in touch with patients, as well as provide them hearing services to ensure they are getting the best possible outcomes during this pandemic.

But many HCPs still ask the question: Are eSolutions, like Remote Support, really for every patient? And, can every patient in the clinic benefit from eSolutions regardless of if they are private pay, direct insurance or TPRN? Clinical considerations as they relate to hearing loss, tech savvy and patient candidacy remain at the discretion of the HCP, as you know your patients best. However, it has never been more important to consider eSolutions in the service delivery you provide your patients, regardless of if they’re private pay, direct insurance or TPRN patients.

Can I use eSolutions with my Managed Care patients?

Of course, it is easy to make the statement that “all patients should be offered eSolutions” in their hearing journey. However, depending on how that patient has arrived at your office, you may be unsure of not only how to offer eSolutions to them – but also if they’re “eligible” to receive and use eSolutions.

But that doesn’t mean you can’t ask the right questions of the insurance vendors, TPRNs and other governance to better understand what your patients’ options may be. Asking questions prepares you with the best information to answer the questions that your patient will most likely ask you during their hearing journey.

Being ready to offer eSolutions

When considering offering eSolutions, like Remote Support, in your clinic, one of the most important considerations you need to make is the product you are fitting. This may seem like commonsense – but as we know, there are many different steps and tools you need to install and setup when preparing to offer in solutions in your clinic. Accordingly, it is easy to forget to ensure that the products you are fitting are capable of supporting a remote patient journey. This is even more important when current and potentially new patients are online, on your website or even in your office. If they notice that you offer remote care, they are most likely going to ask you questions.

Be prepared. Take the time to review your product offering and note which products are remote care capable.

Be prepared. Take the time to review your product offering and note which products are remote care capable. It may also be helpful to review the policies around remote care for any insurance plans or TPRNs with whom you are a network provider, along with the product and service offerings available to those patients.

Managing eSolutions in a Managed Care landscape

Before offering eSolutions to your patients, your clinic administration will most likely want to discuss how to best offer the service, the costs associated with the service, billable components of teleaudiology and associated reimbursement, as well as eligibility per patient (i.e., private pay, direct insurance, TPRN). In our previous blog, we discussed some of the best questions to ask TPRNs to better understand not only how they are reacting to COVID19, but also if and/or how they have changed their policies as it relates to teleaudiology.

As specifically related to eSolutions, some of the best questions to ask insurance plans or the TPRNs to better understand if/how to utilize these tools with such patients may be:

  • How have the policies on teleaudiology changed due to COVID-19?
  • Do teleaudiology visits count towards the patients’ allowed follow-up?
  • Are there any new requirements for you, the provider, due to COVID-19 specifically related to teleaudiology services?
  • Who do you contact if you have any questions?

The digital transformation is here – are you ready?

COVID-19 has truly forced the hand of the healthcare industry to recognize the service delivery methods and options we have available, and whether to adopt or reject them. Business as we know it, and medical healthcare practice, will never resemble the “normal” we once knew. But that doesn’t mean that we cannot or will never be as successful as we were before COVID-19 changed the landscape.

Telemedicine and tools like eSolutions and remote care are not going away. Consumer behavior has undergone a hard and fast shift to digital tools and eCommerce.

Patients are slowly starting to return to the clinic, but we know that some may not return until a vaccine becomes available. The digital transformation in healthcare is here and is starting to take shape, empowering consumers and patients to change how they think about and receive their healthcare services. Accordingly, medical professionals must also consider changing how we offer these healthcare services.

As you look at the future and rebounding from the COVID-19 pandemic, remember to consider the different levers you can rely on to keep your business strong and healthy. Telemedicine and tools like eSolutions and remote care are not going away. Consumer behavior has undergone a hard and fast shift to digital tools and eCommerce. That means that the time is now to better understand what eSolutions and remote care can offer for you, your clinic, your patients – and take the next steps to ensure you’re equipped to use them.

Have a Question?

At Phonak, we strive to be your valued partner, and the resource you trust when you have questions about Managed Care and TPRNs. During these unprecedented times it has never been so important for us to provide you the support and guidance you need. As you are navigating these uncharted waters, our experts and specialists are here to support you. Send us your questions at managedcare@phonak.com, and we’ll do our best to earn your trust!