Baha Upgrade

[2rich2]

I'm new here so I apologize if these questions have already been raised and answered.

I've used the Baha Divino for about 7 years and recently learned of Cochlear's upgrade program.  I'm considering going to the Baha 4, but I have to admit that my expectations for the Divino were never really fulfilled.  It never seemed to really filter out ambient noise, particularly in a restaurant or crowd setting, to the point where I still couldn't hear a person sitting next to me on my non-hearing side.  Is the Baha 4 that much better that it's worth the cost and effort to upgrade?

Also, has anyone used SunMed Medical Solutions (an organization recommended by Cochlear) to assist with obtaining insurance coverage and dealing with my insurance company (at no extra charge to me, from what I've been told)?  Any tips regarding the process and their capabilities are appreciated.

Finally, my audiologist mentioned they charge a $1000 service fee, not covered by insurance, to "calibrate and install" the new Baha device.  This sounds absurd to me, but I was wondering if this was industry practice.  I'm currently seeking out other audiologists in the area (mid-north NJ) to see if this is common.

Thank you!

[arizonajack]

I'm considering going to the Baha 4, but I have to admit that my expectations for the Divino were never really fulfilled.  It never seemed to really filter out ambient noise, particularly in a restaurant or crowd setting, to the point where I still couldn't hear a person sitting next to me on my non-hearing side. 

I have the same problem with my hearing aids which (like others) were hyped to reduce ambient noise. Frankly, I don't think there is a device available anywhere that will actually do that with any degree of satisfaction.

   Is the Baha 4 that much better that it's worth the cost and effort to upgrade?

Have no clue.

But the advantage of hearing aids is that you can try them before making a commitment. I don't know if you can do that with the BAHA.

Finally, my audiologist mentioned they charge a $1000 service fee, not covered by insurance, to "calibrate and install" the new Baha device.  This sounds absurd to me, but I was wondering if this was industry practice.  I'm currently seeking out other audiologists in the area (mid-north NJ) to see if this is common.

I don't know how common it is but any vendor will charge you whatever they can talk you into agreeing to pay.

You are wise to shop around.

My philosophy is: You give me the best deal you can come up with and I'll go compare it to your competitors and see if I can do better. You'd be surprised how fast they include the extras for free if they want to sell it to you.

[leapyrtwins]

Rich -

my first BAHA was a Divino.  I upgraded to the BP100 less than a year later when Cochlear introduced it.  The difference between the two devices was HUGE.  The BP100 is much more like natural hearing, it filters out unwanted noise, works better in large and/or noisy rooms, etc.

I'd image (and I've heard from others) that the differences between the BAHA 4 and the BP100 are huge; so the differences between your Divino and the BAHA 4 would be monumental. 

Not sure why your audiologist would charge you a $1,000 "service fee" - but that's between you and him/her.  Cochlear "allows" docs & audiologists to do this, but it is not a Cochlear fee.  Cochlear doesn't charge the docs/audios a "service fee", nor do they tell them if or how much to charge patients.

Jan

[2rich2]

Thanks Jan,

That information is really helpful.  Unfortunately, my insurance company rejected my initial request for an upgrade because my doctor, who submitted a short letter on my behalf, was not able to prove medical necessity. The insurer is open to a peer to peer review though, so I suppose I still have a chance.

I spoke to another audiologist who has some experience in this area (and won't charge a $1000 fitting fee) and am going to have some hearing tests done with and without the Divino and they believe they can convince my insurer that given the old technology of the Divino, the new technology with the Baha 4 is medically necessary precisely as you describe in your post.

Fingers crossed!

[leapyrtwins]

Rich -

don't know where you are with your request, but it's important to note that Cochlear no longer supports (services or repairs) the Divino.

If nothing else, that should be a consideration for your insurance company when deciding if they will cover an upgraded processor.

Jan

[2rich2]

Hi Jan,

Thank you for thinking of me!  Yes, since my post I submitted evidence to my insurance company that the Divino is no longer supported as well as a letter from my audiologist stating that my current device does not provide the same benefit as the newer devices and is considered obsolete.  I spoke to my insurance company yesterday and they informed me that they are overturning the denial.

Rich

[ANGuy]

I am glad you have the personality to be able to hold your insurance to their commitment to you and that you are able to get upgrades/hardware you are entitled to.  Good job!

[2rich2]

This is not the first appeal I've filed and have been successful each time.  Like most bureaucracies, sometimes insurance companies are just looking to pad their files with information and details supporting a claim that they can fall back on if questioned and it's the insured's job to provide them with that info.  I don't mind it as long as they're punctual and reasonable about reviewing and addressing the claim once they have all the details, background, and facts.  I'm happy to share the contents of my appeal letter privately if anyone is interested.

[leapyrtwins]

Rich -

glad your insurance company has approved the upgrade.

That's great news!!

Jan