For Network Providers
About the HearUSA Hearing Care Network
Benefits of Membership
HearUSA provides its network members patient referrals, quality assurance, cost control and claims management. As a Hearing Care Network member, you will enjoy the following benefits:
- Membership is free.
- No-cost referrals for hearing tests and hearing aids through a variety of benefit programs.
- Claims Support: Claims reimbursement from employers, insurance companies and HMOs.
- Patient Referrals: Lead generation for your practice.
- Advantage Purchasing: Manufacturer discounts on a wide range of products and accessories (including hearing aids, batteries, ear molds, etc.) from brand-name manufacturers.
To become a HearUSA Network Member, call 800-333-3389 or complete this form to request an application.
HearUSA’s Exclusive Partnership with AARP
AARP is a nonprofit, nonpartisan membership organization that helps people ages 50 and over improve the quality of their lives. With more than 37 million members, it is the largest membership organization of its kind. AARP works with various organizations to provide value-added benefits to its members. Through a rigorous selection process, AARP chose HearUSA as its partner to offer a comprehensive hearing care program exclusively for its members. Both organizations are committed to dramatically expanding awareness of hearing loss in America and offering easy, affordable access to professional hearing care and solutions. Through this partnership, AARP and HearUSA work together to develop and implement a national hearing care program that offers real value to AARP members. As a member of the HearUSA Hearing Care Network, you benefit from this partnership in the following ways:
- Become a trusted provider for the ONLY AARP-endorsed hearing care program – the nation’s most influential organization representing people over 50 years of age
. Marketingto 37 million AARP members through multimedia national and regional campaigns, including a variety of AARP platforms (AARP The Magazine which features the world’s largest magazine circulation, AARP Bulletin, AARP VIVA, AARP Member events andAARP.org.).
A successful applicant for participation in the HearUSA Hearing Care Network demonstrates satisfactory professional qualifications and a commitment to the quality standards and cost containment principles of HearUSA.
A HearUSA Hearing Care Network provider:
May beeither an Audiologist or Hearing Instrument Specialist.
- Has an independent practice of audiology and/or hearing aid dispensing or practices as an employee of a physician, a hospital, a medical clinic, an audiologist-managed corporation or another audiologist or licensed hearing instrument specialist who satisfies network criteria.
- Practices at a facility where all necessary equipment for the evaluation of hearing and dispensing of hearing aids is available and regularly calibrated.
- Agrees not to participate in an exclusive arrangement to sell a single manufacturer’s product line of hearing aids.
- Maintains regularly scheduled office hours at each facility where services are provided.
- Maintains professional malpractice insurance with a minimum coverage of $1,000,000/$3,000,000 aggregate and acceptable malpractice history.
- Maintains, or is covered by, adequate general commercial and/or umbrella liability insurance.
- Has completed and signed the Provider Application and Participating Provider Agreement.
Membership is dependent on successful credentialing to NCQA (for accounts regulated by CMS), which may include verification of licensure, education, sanctions listed on the National Practitioner Databank, OIG, EPS, employment history, personal references and presence on the Medicare Opt-Out list. Providers are credentialed as defined by the nature of the contractual agreement.
Applicants whose applications demonstrate, at the sole determination of HearUSA, compliance with these basic criteria shall be eligible for consideration for membership in the HearUSA Hearing Care Network. Membership decisions shall be at the sole discretion of HearUSA and may be based on any factors or information deemed to be relevant by HearUSA.
For current providers, login to the Provider Portal.
Have questions? Call 800-333-3389 with questions about our Hearing Care Network
Provider Frequently Asked Questions
Can I choose to participate in some plans but not others?
We need full participation for all accounts so that we can market accordingly and present a robust network.
Can I participate in the network where there are company owned HearUSA centers?
• For AARP networks, you may participate where there are company owned centers.
• For the insurance network, there may be certain restrictions and certain panels may be closed.
How do I obtain reimbursement for services that I perform?
• Because HearUSA sponsors many different types of plans, please refer to the current version of the plan design. Each plan has instructions regarding services and reimbursement.
• Some plans have insurance payments, some require special authorizations, some are member discount programs, and some have restricted products or other limitations.
How long will it take for me to receive payment?
Reimbursement depends on the plan type. Sometimes we have to await payment from the insurance plan. This could take 30-45 days. In some cases, we have to wait for the member’s return period to expire, and this can also take 45 days.
What should I do if I have not received payment on a claim more than 60 days ago?
Contact us at email@example.com to make sure the claim was received and that all required information is on file.
Are there any fees to join the network?
There are no membership or annual fees for participation.
What are the criteria for joining the network?
•Licensed audiologist or hearing aid dispenser
•Permanent office location with hours posted
•Malpractice insurance coverage
•No licensing violations, exclusions or sanctions from state or federal programs
•Compliance with state licensing regulations (equipment, etc.)
•Completed application and signed agreement
•Compliance with program rules and guidelines
• Approval by the credentialing committee
Which hearing aid brands participate in your programs?
All major brands are available.
Why are the prices so different for every plan?
We make every effort to obtain fair and generous reimbursement levels for our providers. Sometimes the plan mandates certain prices and some plans are for Medicaid members and therefore restricted. Cost controls are important for third party payers, so we work with them to develop the most appropriate pricing structure, depending on the plan parameters.
Do I have to do free testing?
• Audiology testing, which is the only testing covered by insurance companies and Medicare, is outside of the scope of most of our programs. (Check your plan design to confirm.) Medicare doesn’t cover testing for the purpose of hearing aids – if you feel audiology testing is necessary, you will need to discuss this with the member and obtain authorization to bill the insurance payer.
• We offer members a free hearing screening – this is an important part of increasing awareness around hearing loss. Many locations offer free testing, and members will often decline an appointment if there is a charge for the initial visit. If you prefer not to accept appointments for the screenings, we can put your name at the bottom of the list and advise members that you aren’t willing to provide the screening. It’s important for members to know what to expect at the time of the appointment, and we can always refer them to another provider in your area.
What happens if I move my office?
Please contact HearUSA to have your phone, address, email or fax number updated. We need this information to schedule appointments and provide reimbursements. To update contact information, please email: firstname.lastname@example.org
Can I be reimbursed directly to my bank?
Yes, please complete an ACH form to have your reimbursement submitted directly to your bank.
How do I obtain an Explanation of Benefits (EOB) for the payments?
EOBs are emailed to the address indicated on your application. To update it, please email: email@example.com
Why is HearUSA the middle man between providers and the plans?
HearUSA performs many services on behalf of the plan for members and payers. Examples include:
• Administer oversight of all provider credentialing to represent a standard and quality professional to the payer marketplace.
• Market the value of high-quality hearing services and products to the paying members as well as to the general consumer, thereby eliminating new patient acquisition costs.
• Contract and coordinate the inclusion of hearing care and hearing aids within health benefit plans and programs.
• Develop and manage the provider network to create access to qualified providers and streamline benefits and reimbursement.
• Coordinate benefits and eligibility verification on behalf of individual providers under specialty care contracts with payers.
• Advise large payers, and other plans developing specialty care protocols, on the value of adding hearing to their plans. Represent the standardized clinical protocols that are adhered to by professionals within the hearing care industry
• Educate administrators on the mental, physical and economic impact of untreated hearing loss.
• Advocate with all involved constituents including payers, medical plans, hospitals, trade associations, policymakers and the government, etc., for the value of hearing care and hearing aids.
HearUSA spends millions of dollars to market provider practices across the country. We refer callers to your practice, and require compensation for the services that we provide.