The Official Publication of The Academy of Doctors of Audiology®

Transcription

feedback
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18
25
Paul M. Doolittle
on compensation
for occupational
hearing loss.
A review of
laws governing
phone design and
hearing aids.
2007 ADA
Convention
Wrap Up.
Source:
7 Your
ADA’s Web
Site Is Available
To Help You
President’s Message: 2008: The Next Evolution of the Revolution
My Life Is: Gretchen Syfert,Au.D. and Nancy Green,Au.D.
State Licensure Round Up: A Look at the Process in Arizona and Maryland
VOLUME 18, NUMBER 4 ■ WINTER 2007
feedback
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T
President’s Message
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Editor’s Note
Nancy Gilliom, Ph.D.
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Your Source: ADA’s Web Site
Is Available to Help You
T
S
ADA Update
Changing of the Guard
Save the Date!
David A. Berkey, Au.D.
6
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22
State Licensure Round Up
24
My Life Is…
Nancy Green, Au.D.
14
Compensation For
Occupational Hearing Loss
25
Paul M. Doolittle
17
My Life Is…
Gretchen Syfert, Au.D.
18
Hearing Aid Compatible
Phones: Laws That You
Need To Know
Brenda Battat, MA, MCSP
Advertisers Index
Oticon • Epoq..............................Inside Front Cover
Phonak Audéo...........................................................4
Siemens Hearing Instruments..............................13
26
28
ADA Convention 2007
Wrap Up: Q&A With
New ADA President
ADA Convention 2007
Wrap Up: Successful
Launch Photo Collage
Professional Update
Discovery Hearing Aid Warranties.......................16
Widex ............................................Inside Back Cover
Maico Diagnostics ..................................Back Cover
All advertisements sent to Feedback and the Academy of Doctors of Audiology for publication must comply with all applicable laws and regulations. The
appearance of advertisements in Feedback magazine is not an endorsement of the advertiser or its products or services. Neither Feedback nor the ADA
board investigates the claims made by advertisers and is not responsible for their claims.
FEEDBACK • VOLUME 18, NUMBER 4 • WINTER 2007
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President’s Message ADA
President’s Message
2008 – The Next Evolution of
the Revolution
ADA President
I
often hear from you, our members, that ADA is your “professional home.”
For 30 years we have served as a resource for audiologists who own, work
in, or have a strong interest in audiology private practices.This year’s outstanding program at the Fall Convention in Orlando reinforced that theme.
For those of you unable to
attend, you missed not only
some unique programming,
but great opportunities to network with audiologists in different career stages, and with
our industry partners. The
casual atmosphere and social
events captured our traditions,
and left us recharged to come
home and begin another cycle.
Those of you who were there
need to tell your colleagues and
make sure we see them at the
next convention!
2008 Fall Convention
In our 2008 convention we
will reinforce our dedication
to the “business of audiology.”
There will be some changes to
our traditional format that will
allow us to provide an even
better experience, while being
mindful of your scarcest
resource – time.
The venue is The Green
Valley Ranch Resort, just
outside of Las Vegas, Nev.,
November 6-8, 2008. This
outstanding property has all the
usual amenities – and then
some – while being away from
the congestion of the Strip.We
have remodeled several aspects
of our meeting schedule to
shorten it by one work day –
meaning less time away from
your practice – while still
maintaining the high quality
you have come to expect.
Mark your calendars now and
save the dates for this not-tobe-missed event!
Spring Summit
In Orlando I spoke about
how what truly sets ADA apart
from other organizations is a
sense of Community among
its members. We have been
Comrades in Arms, David’s
against the Goliath’s, and a
source of wonderful support
for one another all along the
way. But the spirit of Community is ultimately fragile. If it is
not nurtured and cultivated in
those who succeed us, it can
eventually dissipate.
It has been nine years since
ADA members have come
face-to-face for any kind of
organization-wide brainstorming session. 2008 will be
the 20th anniversary of the
birth of the Au.D. degree concept within our organization.
Additionally, in 2007 ADA has
set forth a new Vision for the
profession to move audiology
from its cur rent “wage
employment” model to one of
an “ownership” model. With
this next evolutionary step on
the drawing board, your
Board’s plan calls for a day-long
ADA Summit meeting this
coming spring. This meeting
will be our opportunity to
bring new and old visionaries
together and re-connect with
our community in a facilitated
activity to further define this
mission. At the Summit conclusion we will have an action
plan for future directions of
ADA and a start on the
roadmap for getting there.
The ADA Summit will
occur on Tuesday, April 1,
2008. Since a significant number of our members typically
attend the American Academy
of Audiology (AAA) convention,your Board has decided to
hold this Summit in Charlotte,
N.C., a day ahead of any AAA
programming. There will be
no charge to ADA members
for this event. Watch your
mailboxes for your invitation
to this event, along with additional descriptive and logistical
information. So once again ...
mark your calendars and save
the date!
“Getting to Know You”
Survey
I have also recently devel-
oped a tool designed to fuel
the community building
process,and that is an in-depth,
non-anonymous survey of our
membership, with a lot of
open-ended questions to help
us match your interests and
needs to the resources of our
organization. If you have not
already done so, please complete this survey, which you
can fill out online (or longhand in a downloaded copy
and fax-in to our headquarters).
You may find links to the survey
at www.audiologist.org/
member_survey.cfm. From
this data we will also be able to
“partner,” or “match” people
involved in, or considering private practice with non-competitive mentors that have dealt
with and resolved similar issues.
I am very excited about our
upcoming year and everything
that is planned, and hope you
will join me in my enthusiasm
and contribute with your volunteer efforts to make 2008
the very best year yet for ADA!
Respectfully yours,
David A. Berkey,Au.D.
President,Academy of Doctors
of Audiology
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ADA Editor’s Note
Editor’s Note
President
David Berkey, Au.D.
[email protected]
President Elect
Charles Stone, Au.D.
[email protected]
Share Your Song
Association Coordinator
Alexis Bauer
Last week, I was driving to an out-of-town contract enjoying a new playlist
I hurriedly added to my iPod that morning. Driving back country roads, I was
air-directing the Glenn Miller Orchestra play Jumpin’ Jive, then listening to the
voice of Josh Groban drive notes and phrases into my soul with Oceano.Around
the bend, I began singing with JT (James Taylor for the younger crowd) to Shed
a Little Light, and as I passed the pasture of cows, I was crooning with Rascal
Flatts’ My Wish.And, during the stretch of miles-to-no-where, I was chair-dancing to Band of Gold,
whistling reggae with Bob Marley, drumming a beat to Walking on Broken Glass by Annie Lennox,
and with my car lighter doubling as a microphone,I was wailing the lyrics to Listen sung by Beyonce´´
(and me, of course) in Dream Girls. As the songs continued from one genre to another and one
decade to another, I started smiling and actually laughing to myself, as I thought, ?_What an eclectic group of songs!’The one song that got me thinking that morning was Wake up Everybody by
Harold Melvin.
Here I was, 13 years now, headed down the back roads of Florida, dancin’, singin’, entertaining
myself… and I started to really hear the lyrics of Wake Up Everybody. “Wake up everybody no
more sleepin’ in bed. No more backward thinking, time for thinkin’ ahead.The world has changed
so very much from what it used to be ... there is so much hatred, war an’ poverty.Wake up all the
teachers …… wake up all the doctors …… wake up all the builders …… The world won’t get no
better, if we just let it be …… The world won’t get no better, we gotta change it, yeah, just you
and me.”
Throughout this year in my editorials, I have written about change in our profession, being part
of a team in our audiology community, and sharing and honoring the inner light that many of us
have in ADA. Today, as I think about our new president’s plans to help refuel and cultivate our
audiology community, I am singing to each of you to help take care of our academy… our
audiology world. ADA is a fellowship of individuals from different “genres” and from different
decades…an eclectic group – individually we will keep ourselves entertained, laughing, smiling,
singing and building our own businesses. But together, we can change our world. Our professional fellowship needs to be nurtured. It is time to Wake up Everybody. Come and lend a hand.Take
time to complete the member survey and be an active part of our fellowship.
The world won’t get no better if we just let it be.The world won’t get no better we gotta change it, yeah, just
you and me.…… can’t do it alone …… need some help ... can’t do it alone …… wake up everybody……
need a little help…… yes we do……
Bring your own song to this great party,
ADA Headquarters
401 North Michigan Avenue
Chicago, IL 60611
Nancy Gilliom, Ph.D., Feedback Editor
[email protected]
Past President
Larry Engelmann, Au.D.
[email protected]
Treasurer
Tabitha Parent-Buck, Au.D.
[email protected]
Secretary
Susan J. Williamson, Au.D.
[email protected]
Members At Large
Gail B. Brenner, Au.D.
[email protected]
Susan Parr, Au.D.
[email protected]
Gretchen Adams Syfert, Au.D.
[email protected]
Feedback Editor
2051 Art Museum Drive, Suite 130
Jacksonville, FL 32207
Phone: (904) 399-3323
[email protected]
Publisher
Jay Strother
[email protected]
Managing Editor
Theresa Rubinas
[email protected]
Advertising
M.J. Mrvica Associates
(856) 768-9360
[email protected]
Executive Director
Kevin Hacke
Association Manager
Erin Butler
(866) 493-5544 or (312) 527-6748
Fax: (312) 673-6725
Feedback is the official publication of the Academy of
Doctors of Audiology ®. Feedback is published four
times a year with deadlines of January 15, April 15,
July 15, and October 15. Contributions are welcomed but
the Editor reserves the right to accept or reject any
material for publication. All articles published in this
magazine represent solely the individual opinions of the
writers and not necessarily those of the Academy of
Doctors of Audiology®.
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MISSION STATEMENT
It is the mission of Feedback to provide doctoral-level technical, professional, business, and Academy information in a way
that prepares the ADA membership to achieve professional success, and ensure that Audiologists have the choice of
practicing autonomously as the recognized leaders in hearing and balance care and dispensing hearing instruments.
Continued On Next Page
7
Feature Your Source: ADA’s Web Site
anaging a successful audiology practice requires business savvy, technical skill, legal knowledge and people management skills, to name a few. Practicing audiologists must adhere to specific laws to ensure
that they are in line with government regulations. These licensure laws include everything from
HIPPA compliance, to insurance laws, to billing, coding, reimbursement and compliance.
Because these laws are often extensive and constantly changing, memorization is not really an option. For this reason, ADA Headquarters contracted member Kimberly Cavitt, Au.D., president, Audiology Resources, Inc., Chicago,
Ill., to help fill in the blanks.
Cavitt provides extensive updates on laws and regulations to help keep members informed.This information is available on the ADA Web site at www.audiologist.org/professionals/promanagement.cfm.
M
AUDIOLOGISTS, HIPPA,
REGULATIONS AND
LICENSURE LAWS
Complying with HIPPA
The Health Insurance Portability and
Accountability Act (HIPPA), was signed
into law in 1996. Its primary purpose is to
provide continuous insurance coverage for
workers who change jobs so that health
insurance is “portable” from one employer to the next.
Although HIPPA has many components, the “Accountability” section, also
known as the Administrative Simplification
section of Title II, effects the day-to-day
operations of audiology practices.
Title II: Administrative Simplification
Compliance Act (ASCA) established rules to
improve the efficiency and effectiveness of
the nation’s health care system by encouraging the widespread use of electronic data
interchange in health care, resulting in
reduced costs. The rules also protect and
secure an individual’s identifiable personaland health-related information.
Following the requirements of the
Administrative Simplification Compliance
Act, the United States Department of
Health and Human Services established
national standards in three areas: Privacy,
Secur ity and Electronic Data
Interchange.
Impact of Rules on Audiology
Practices
Privacy Rule
Under the new regulations, audiology
practices will be required to notify patients
of their privacy rights and policies before
treatment.Patient consent will be necessary
for the release of private health information
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be included along with authorization
for use of the patient’s private health
information for business-related purposes of marketing, release of information to insurance car r iers and
manufacturers, etc.
Providers may see patients who do not
provide this written authorization,but only
for purposes of treatment, payment and
operations.Audiologists must continue to be
vigilant in obtaining written consent before
releasing medical information to the patient,
referring physician,school,etc.Patients may
deny consent at any time in writing.
for anything other than treatment, payment and operations. Audiology practices
will need to create a specific authorization
form for use in their office. This form
should contain at least the following minimum information:
• What personal health information is
being used or disclosed
• Who is authorized to make the disclosure of information
• Who is authorized to receive the disclosed information
• A statement informing the patient that
he or she may revoke authorization in
writing and exceptions to the right to
revoke
• A statement indicating that information that has already been disclosed
may no longer be protected
• The patient’s signature and date should
Confidentiality
Providers will also have to continue to
use their best judgment with regard to
discussions about individual patients
with other professionals. Discussions
with other health care providers who
are involved in the patient’s care, teachers, parents, manufacturers, etc. will be
protected under the Act.Also, the ASCA
will not restrict providers from using
sign-in sheets, keeping files in a bin on
their desk until the patient arrives, or
calling a patient’s name when the audiologist is available.
Obtaining/Releasing Records
The Privacy portion of Administrative
Simplification will prohibit the use of
patient records and information for marketing purposes without the patient’s
written authorization or unless certain
conditions are met. For example, if you
want to send a hearing aid direct-mail
piece to your patient database, the piece
must adhere to specific guidelines.
• It must contain your address and/or
phone number
Your Source: ADA’s Web Site Feature
• It must indicate if the audiologist is
being compensated for the piece
• It must tell recipients how not to
receive further marketing pieces
• It must explain why this particular
patient is receiving the marketing piece
and, how it relates to their condition,
and how it may benefit him or her.
If the piece does not contain this information, you need the patient’s authorization to send him or her marketing
materials.
Security Rule
Each audiology practice must have
secure computer and e-mail access. For
example, audiologists should actually enter
initials and passwords to access NOAH
rather than “ABC” and “123.” Audiology
practices must have policies and procedures that outline how information is
stored electronically in their offices, who
has access to this information and how this
access is policed. All office management
software should have individual user names
and passwords. Offices should ensure that
they have secure systems and connections.
They also must ensure that all data is
backed up in the event of an emergency. It
is important to note that telephone
exchanges,fax transmissions or paper medical records (i.e. charts) are not covered by
this standard.
Transactions
The Transaction subsection of EDI covers the way one entity transmits claims to
another. All providers, insurance carriers
and clearinghouses must be able to electronically send and receive claims and must
use a standard form or mechanism (i.e. the
red HCFA 1500 for Medicare and
Medicaid or additional forms required by
private insurers such as Blue Cross and
Blue Shield) to transmit and process claims.
In other words, audiologists will be
required to submit claims electronically to
Medicare and private insurance carriers.
Failure to file electronically may result in
exclusion from Medicare and Medicaid
programs. Some smaller practices may be
able to receive an exemption from
Medicare or Medicaid with regard to electronic claims submission, but private insur-
LEGISLATIVE UPDATES
• Centers for Medicare and Medicaid Services:What’s New - http://cms.hhs.gov/
providerupdate/whatsnew.asp. Stay informed about changes in CMS regulations
right from the source. Sign up for the CMS-QPU Listserv to receive periodic e-mail
messages throughout the quarter as regulations and program instructions are added
to the CMS Quarterly Provider Update.
Office of Civil Rights: What’s New In Privacy – www.hhs.gov/ocr/hipaa/.
Visit the Office of Civil Rights “What’s New” section for timely updates and answers
to frequently asked questions.
HIPAA Advisory: Latest News – www.hipaadvisory.com/latest.htm
Read the most recent additions to the HIPAA Advisory
For more HIPPA resources, visit www.audiologist.org/professionals/
HIPAA/resources.cfm.
ance carriers,with whom audiologists contract, may refuse to process paper claims
submitted by providers.Audiologists would
need to complete the extension form available from CMS to request an exemption
from electronic claims submission.
Ultimately, it is in the practitioner’s best
interest to move toward electronic claims
submission, regardless of the size of his or
her practice. This mode of transmission
allows for confirmation of receipt of the
claim, faster processing, less human error,
and thus, improved cash flow.
Coding
All providers, insurance carriers and
clearinghouses will be required to use
the same set of codes to represent various services and procedures. This standard will be the easiest for audiologists
to implement as most of us typically
already are using the required code sets
of the International Classification of
Diseases, 9th Edition (ICD-9), Current
Procedural Terminology (CPT) and the
Healthcare Financing Administration
Common procedural Coding System
(HCPCS). Local codes typically used by
Medicaid to represent audiology and
hearing aid services will be eliminated.
Medicaid is going to be required to use
CPTs and HCPCS codes to represent
these services and not a regional code
created specifically for their state.
National Provider Identifier
This rule mandates the use of a single,
10-digit National Provider Identifier
(NPI) number to identify each provider
when submitting claims to all insurance
car r iers, including Medicare and
Medicaid. If an audiologist is a HIPAAcovered provider or if he or she is a
health care provider who submits claims
to Medicare, he or she must obtain and
utilize an NPI.The NPI replaces all other provider numbers currently being
used to identify an audiologist when he
or she submits a claim to an insurance
carrier and it can move with a provider
from employer to employer. An NPI is
required if an audiologist wants to enroll
with Medicare.
Compliance Dates
May 23, 2008 – Compliance date for
National Provider Identifier – small health
plans – Visit the CMS Web site, www.cms.
hhs.gov for more information.
Understanding Billing, Coding and
Reimbursement
As Audiology transitions to a doctoring
profession,one point has never been clearer:
The success (or failure) of an audiology practice will depend largely on the audiologist’s
awareness and understanding of billing,coding, reimbursement and compliance.
Reimbursement is what brings revenue
to a business, pays the operating expenses
and pays for salaries. Even a busy practice
employing state-of-the-art methods and
products will suffer if it maintains antiquated office management and billing systems. A strong grasp of reimbursement
issues and application of modern office
management processes is necessary to run
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a profitable business. But profit is not the
only benefit; a well-managed business creates a lasting impression of professionalism.
Consider the following facts:
• According to a Report by the Centers
for Medicare and Medicaid Services
(March, 2003), 86 percent of the U.S.
population has some form of health
insurance coverage.
• Almost 14 percent of the U.S. population has Medicare coverage.
• A U.S. Census Bureau survey reported
that almost $14 billion dollars was spent
by private insurance carriers for services rendered to ancillary health
providers in 2001.That number represents a 21 percent increase from 1998.
Health insurance is an integral component
of American life; therefore, it is incumbent
upon audiologists to be active, knowledgeable and savvy participants in the managed-care arena if they want to be part of
a viable, autonomous health profession.
ADA Web site has a reimbursement section that is designed to offer tools and
resources to help busy practitioners stay
on top of this ever-evolving reimbursement arena.
Effective Reimbursement:A Checklist
for Audiology Practices
Successful audiology practices use a
number of procedures and protocols to
stay in compliance with Federal and State
laws, while keeping an eye on efficiency,
• Photo copy (both sides) patient’s insurance cards.
• Collect co-pays, deductibles, charges,
deposits and purchase payments at the
date of visit.
• Create and use a standardized Superbill
for every patient encounter; it should
contain all of the CPTs, ICD9s and
HCPCS codes that are used on a daily basis.
• Cross check the Superbills to the clinic schedule each day to ensure that
every patient is accounted for.
• Create and use an Advance Beneficiary
Notice and accompanying explanation
sheet for use with Medicare recipients
whenever necessary. When using a
signed ABN, add the modifier GA
(Waiver of Liability Statement on File)
to your claim. This form will notify
Successful audiology practices use a number of procedures and
protocols to stay in compliance with Federal and State laws, while
keeping an eye on efficiency, simplicity and patient satisfaction.
simplicity and patient satisfaction.The following checklist was developed for the
ADA membership to help identify areas
that may improve practice management
efficiency:
• Create and use a patient registration form
that includes insurance information.
• Verify demographic and/or insurance
information at every patient appointment.
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Medicare of the existence of a signed
ABN and allow Medicare to reflect
patient responsibility on all Explanation of Benefits.
• Create and use a Notice of Exclusion
from Medicare Benefits (NEMB).This
form is used to inform Medicare beneficiaries in advance that Medicare does
not cover certain items and services
(i.e. hearing aids, tinnitus retraining
therapy,canalith repositioning) because
the item or service does not meet
the Medicare definition of a benefit,
or because the item or service is specifically excluded by law.While this form
is not required by Medicare, it is very
useful for notifying patients of their
financial responsibility.When this form
is used, do not submit any claim
to Medicare.
• Electronically submit all claims within
one business day of completing the
service.
• Maintain current copies of CPT, ICD9
and HCPCS manuals.
• Establish a strict claims denial process.
• Evaluate each carrier’s reimbursement
schedule. Base decision to participate
on individual practice situation. A
provider is not required to contract
with carriers whose reimbursement is
not adequate.
• Establish a strict hearing aid and hearing aid-related service payment policy;
goods and services should be paid in
full by the day of delivery.
• At a minimum, establish a non-refundable hearing aid evaluation charge and
collect it on the date of a hearing aid
order and/or the date of the hearing
aid evaluation. [Note: Practitioners
should follow state regulations under
their business code practice guidelines
for non-refundable fees, if any.]
• Do not offer payment plans unless they
are underwritten, financed and/or
administered by a separate financial
company or lending institution.
Your Source: ADA’s Web Site Feature
• Accept credit card payments.
• Secure the services of a third-party
financing company that your patients
can use for hearing aid financing needs.
Negotiate the percentage that the
company keeps for their services. Do
not provide your own direct financing.
• Establish a bad debt/unpaid balance
write-off policy.
• Establish a strict collection policy and
use a collection agency.
• Review accounts receivable on a
monthly basis.
• When contracting for hearing aids,
carve hearing aid coverage from managed-care contracts whenever possible
so your practice is not obligated to
accept their payment schedule for
amplification. Specifically this means
that when negotiating an insurance
contract including hearing aid coverage, try to exclude the hearing aid coverage within the terms of the entire
contract or create a contract portion
specific to hearing aids that is more
favorable to your practice.
• Avoid ‘invoice plus hearing aid coverage’ contracts; the best hearing aid
coverage contracts allow for a defined
maximum amount per defined time
period (i.e. $1,200 benefit every 36
months).
• Purchase and use office management/billing software.
• Evaluate your hearing aid-related pricing on at least an annual basis and determine if you are receiving the maximum
discounts possible. If not, renegotiate
with manufacturers and vendors or
investigate making your purchases
through a buying group.Buying groups
can often provide discounting that is
unavailable to smaller practices.
Coding
CPT® is an acronym for Current
Procedural Terminology. CPTs are fivedigit numeric codes, created and owned by
the American Medical Association, to
describe medical services and procedures.
(Most audiology-related codes begin with
the numbers 92-.) These codes are added,
deleted and modified annually.As ancillary
medial professionals, it is important for us
to consider that CPTs are created by the
AMA, especially when we question the
presence or absence of particular codes
or procedures.
Coding and billing for audiological services is a complex task. Payment for services requires the use of specific coding
systems that indicate patient diagnoses,
services and procedures. It is imperative
that practitioners invest the time to learn
correct coding procedures or else payors
When it comes to CPT codes one basic
premise applies: always select coding that
legitimately represents all of the procedures that were completed on each individual patient. Remember, third-party payers,
particularly Medicare,cover only the procedures needed to diagnose an otologic or
auditory disorder in a patient. “Routine”
services are typically non-covered. For this
reason,use of an Advance Beneficiary Notice
(www.cms.hhs.gov/BNI/02_ABNGA
BNL.asp) is essential. The Advance
Beneficiary Notice allows your practice to
bill Medicare recipients directly (privately)
for non-covered services (i.e.routine audiograms,audiograms for the purpose of obtaining a hearing aid, cerumen removal).
CPT Tips
• Use various coding combinations to
legitimately increase reimbursement,
Coding and billing for audiological services is a complex task. Payment
for services requires the use of specific coding systems that indicate
patient diagnoses, services and procedures. It is imperative that
practitioners invest the time to learn correct coding procedures or
else payors may not understand the services or products used and
will automatically refuse to pay, or pay at a minimal rate.
may not understand the services or products used and will automatically refuse to
pay, or pay at a minimal rate.
The Academy of Doctors of Audiology
offers a number of resources for practitioners to stay current on acceptable coding practices. Within the coding section
of the Web site, www.audiologist.org/
professionals/reimburse/coding.cfm,
you will find tips and “do’s and don’ts” for
using CPT codes, ICD-9 codes and
HCPCS codes.
To obtain a copy of the current CPT Manual by mail contact:
American Medical Association, 515 North State Street, Chicago, IL 60610
800-621-8335
If you have any specific questions, visit the reimbursement forum, www.
audiologist.org/community/ or send an e-mail to the ADA Help Desk,
www.audiologist.org/secure/contact/.
especially in certain situations such as
pediatric testing, central auditory processing evaluations, vestibular testing,
and cochlear implantation.
• It is completely legitimate to bill for
procedures that were attempted, but
where no data could be gathered (such
as conditioned-play audiometry where
the child would not condition).
Document the situation in the patient’s
file and/or on the audiogram form.
• Do not un-bundle procedures as it may
result claim denial or reduced reimbursement.
EXAMPLE
Do not bill 92553 for pure-tone air and
bone and 92556 for speech-awareness
threshold and speech recognition rather
than 92557 for a comprehensive audioContinued On Next Page
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she must add a –52 modifier (Reduced
services) to reflect that only one ear was
tested.
• 92586 (ABR; limited) and 92587
(OAE; limited) are screening measures,
often used in infant screening
• 92585 (ABR; comprehensive) and 92588
(OAE; comprehensive) are clinical or
diagnostic measures
• Make sure you fulfill all of the criteria
of 92588 (multiple levels and frequencies)
• Bill 92547 (Use of vertical electrodes) as
many times as needed in association
with each ENG code (92541-92546);
if it is clinically useful to you to have
vertical electrodes in place,bill for those
procedures.
• Medicare does cover ear protector evaluation measures (92596)
gram, which includes the two former
procedures.
• Do not use CPT codes that are not
specific to audiology/otolaryngology
services. Use of these codes will result
in claim denial.In the case of Medicare,
audiologists cannot bill for Evaluation
and Management codes; however, they
are acceptable codes for many private
carriers.As a manager of Hearing and
Balance care you may bill Evaluation
and Management codes. Your report
to the patient’s physician should
include the following sections: History,
Diagnosis and Treatment.
EXCEPTIONS
• If you bill out services under your
physician-employer’s UPIN number
• If you are billing for intraoperative
monitor ing cerumen removal or
canalith repositioning
Request a signed Advance Beneficiary
Notice (www.cms.hhs.gov/BNI/
02_ABNGABNL.asp) in these cases
as you will probably be denied for all or
part of the charge.
12
• If there is no CPT code for the service the audiologist is providing, use
92700 (Unlisted otorhinolaryngological
service or procedure). When filing the
claim, include a full description of the
procedure and documentation supporting its need.Also submit a fee that
reflects what the procedure is worth.
Consider having the patient private
pay for these services.
• Require patients to private pay for
services that have no billable code
(i.e. canalith repositioning, tinnitus
evaluation and retraining, certain central auditory processing procedures)
• Audiology procedures are assumed to
possess both the technical and professional component.
• Use modifiers to better illustrate the
services provided to ensure appropriate reimbursement. Most audiology
codes imply that both ears are being
tested.
EXAMPLE
Patient F is having a post-op hearing
evaluation on his operative ear only. If
Audiologist G billed for 92557 he or
The Academy’s Web site offers a wealth
of valuable information for the professional
in private practice. An up-to-date list of
CPT, ICD-9, HCPCS codes are available
under the “professionals” tab. In addition,
members will find generic ready to download Advance Beneficiary notice,Insurance
verification forms, and Superbills. If you
have questions and need resources about
regulations and coding, use your
Academy… we are your source. ■
DISCLAIMER:The foregoing information is
provided as a resource for our members. It is not
intended and should not be construed as an
endorsement of any of the vendors or their products or services; as such, ADA makes no warranty whatsoever, either express or implied,
including the warranties of merchantability and
fitness for a particular purpose regarding any of
the products listed above and makes no recommendation as to the accuracy or suitability of the
information for your particular situation.ADA
members are encouraged to seek legal counsel to
ensure compliance and are responsible for their
own knowledge of both federal and state policies
as it pertains to HIPAA.Neither ADA,nor any
of its officers, directors, agents, employees, committee members or other representatives shall
have any liability for any claim, whether founded or unfounded,of any kind whatsoever,including, but not limited to, any claim for costs and
legal fees, arising from the use of these opinions.
Paul M. Doolittle
14
Feature
lmost all states provide
compensation benefits
for occupational hearing
loss. Exposure to noise is
one of the most common
occupational diseases:
tens of millions of U.S. employees are
exposed to injurious levels of noise on the
job. Unfortunately, many employees are
not able to wear hearing protection inasmuch as doing so would impair their ability to hear co-workers, equipment, backup
alarms, and so forth.
Occupational noise is most frequently
found in heavy industry, as well as routine
equipment used at many job sites, such as
generators, engines and other machinery.
OSHA (Occupational Safety and Health
Administration) requires that when an
employee’s exposure equals or exceeds an
eight-hour, time-weighted average of 85
decibels, the employer must adopt a hearing-conservation program. A typical leaf
blower, according to an industry lobbyist,
produces 70-75 decibels at 50 feet: obviously, the employee operating the leaf
blower is exposed to much greater levels.
Data from audiometric testing of members of the Laborers’ Union has shown that
39 percent of members (average age 51)
have significant loss. NIOSH (National
Institute for Occupational Safety and
Health) estimated that a 25-year-old construction worker has the hearing of a 50 year
old without occupational noise exposure.
The supplied chart indicates that almost
all construction equipment produces injurious levels of noise: A circular saw and
simple hammering produce a whopping
96 decibels!
Chronic exposure to noise frequently
produces an occupational hearing loss,
which then generates a claim for compensation, and, in many cases, the need for
hearing aids. Compensation schedules differ according to state, and according to
whether the employee suffers a monaural
or binaural loss. In some states, the maximum compensation award may exceed
$100,000. Many states do not deduct for
presbycusis. In addition, many award compensation for tinnitus. According to the
Guides to the Evaluation of Permanent
Impairment (AMA Guidelines 2005),
A
Common Construction Tools or Tasks
Noise Level dBA, Leq.
Reference
110
CSM*
102-104
CSM
Air Track Drill
113
BC**
Bobcat Driver
87.7
BC
101-103
CSM
Bulldozer - Insulated Cab
85
CSM
Bulldozer - No Muffler
107
CSM
Chipping Concrete
97
CSM
Circular Saw and Hammering
96
CSM
Compactor
108
BC
Compactor on Cab
94
CSM
Compressed Air Blower (100 PSI)
Blowing Out Cuts
104
AIHA***
62-92 (79 avg)
BC
Concrete Finishing - Electric Grinder,
Chipping and Patching
91.3
BC
Crane - Uninsulated Cab
102
CSM
Crane - Insulated Cab
90
CSM
89-103
BC
102
BC
86-90
BC
91.4
BC
85-91
BC
Grader, Trucks, Concrete Pumps
& Mixers, Generators
<85
BC
Hammer Drill, 1/4" Bit Drilling Holes
into Concrete
95.7
AIHA
90-100
BC
Impact Wrench
108
CSM
Jack Hammer
96
CSM
Air Arching Gouging
Air Grinder
Bulldozer - No Cab
Compressors
Dozers, Dumpers
Electric Drill
Excavators
Foreman (Concrete Vibrator
Used for Pour)
Front - End Loaders
Hydraulic Breakers
*CSM - Dru Sahai, “Hearing Conservation - How to Prevent Noise-Induced Hearing Loss in
Construction,” Construction Safety Magazine, August, 2000.
*BC - Heather Gillis and Christine Harrison, “Hearing Levels and Hearing Protection Use in the British
Columbia Construction Industry - 1988-1997,” Workers’ Compensation Board of British Columbia.
***AIHA - Richard Neitzel et al., “An Assessment of Occupational Noise Exposures in Four
Construction Trades,” American Industrial Hygiene Association Journal, 60: 807-817 (1999).
Reference: Laborers’ Health & Safety Fund of North America, http://www.lhsfna.org
15
Feature Compensation for Occupational Hearing Loss
“Tinnitus in the presence of unilateral or
bilateral hearing impairment may impair
speech discrimination.” Therefore an
impairment rating of up to 5 percent
may be added if the tinnitus
impacts the ability to perform
activities of daily living.
Almost all states provide
for hearing aids, and
many states do
not penalize the
employee for a
pre-existing hearing loss. However,
some states penalize
employees for not wearing
hearing-protection devices.
In Florida, where I practice, the
Flor ida Unifor m Per manent
Impairment Rating Schedule is almost
identical to the Amer ican Medical
Association’s Guide to the Evaluation Of
Permanent Impairment, 5th Edition. In
essence, each ear is tested separately with a
pure-tone audiometer, and the hearing
Audiologists play a critical role
in these cases: It is usually the
audiologist who first confirms
a noise-induced hearing loss,
thereby triggering the statute
of limitations.
levels are recorded at 500, 1000, 2000 and
3000 Hz.The four hearing levels for each
ear are added separately, and various tables
are used to determine the percentages of
monaural or binaural hearing impairment,
conversion of monaural to binaural hearing
impairment, and whole person impairment. Based upon these tables, compensation is then awarded to the injured
employee. Appropriate medical benefits,
i.e., repeat audiograms, hearing aids and
batteries are also awarded.According to the
United States Department of Labor,
between 1999 and 2000, 6,745 claims for
hearing loss were submitted, at a cost of
almost 40 million dollars, of which almost
nine million dollars was for medical care.
16
The average award for compensation was
almost $6,000. As such, occupationally
induced hearing loss is a significant problem for employers and their compensation carriers, not to mention the
employees (and their families)
who are injured as a result
of same.
The statutes of
limitation
for
bringing hearing
loss claims are usually one to two
years. For an excellent
discussion of the state
statutes, see The Noise
Manual, 4th Edition, published
by AIHA Press (manual may be
ordered at www.aiha.org). Audiologists play a critical role in these cases: It is
usually the audiologist who first confirms
a noise-induced hearing loss, thereby triggering the statute of limitations. In most
cases, the statute begins to run when the
employee first learns (rather than guesses)
that his hearing loss is
related to his employment. In some cases,
the statute does not
begin to run until the
employee is provided
with a written report,
from the audiologist,
confirming the relationship between his
employment and loss.
A thorough history
including types of previous employment
related noise exposure
or recreational noise
(firearms, loud music,
auto mechanics, construction work, etc.)
should be obtained, as
well as, relevant medical history (head trauma, ear disease, family
history of hearing loss,
etc.). If a hearing loss is
identified and hearing
aids are recommended,
whether it be occupationally noise induced,
recreationally induced,
presbycusis, congenital loss, etc., it is up to
the hearing-impaired individual to take
appropriate action.
Audiologists offer expert testimony on
behalf of both injured employees and
employers/carriers. Moreover, audiologists
assist the parties with respect to amplification issues; as such, they work closely with
workers’compensation insurance adjusters,
nurse case managers, and risk managers.
Utltimately, hearing-conservation programs should be implemented and monitored to minimize losses, but when a loss
occurs that is the likely result of noise
exposure in the workplace, the audiologist,
in my opinion, has a professional duty to
advise the patient, in writing, that his hearing loss is occupationally induced. ■
Paul M. Doolittle practices law in
Jacksonville, Fla: he has prosecuted hundreds
of hearing loss claims on behalf of employees,
including longshoremen and shipbuilders.
of her wildest dreams at the
Gretchen Syfert lives out one
race track.
Gretchen Adams Syfert,Au
.D.,is currently serving as
member-at-large on the AD
(for the second time). She
A Board of Directors
also served on the conven
tion committee and is pres
Paper task force. Dr. Syfert
ently on the White
is recently retired from priv
ate practice in Arlington
and Alexandria,Va.
and now lives in Merrit
t Island, Fla. She is serv
ing as a Guardian ad Lit
county court system, volu
em for children in the
nteers in the elementary
school system, is active in
very busy with her three
her church and is kept
young grandchildren and
an extensive travel schedul
e.
My Life Is… ADA
My Life Is…
17
Brenda Battat, MA, MCSP
18
Feature
udiologists are ideally
placed to be a source
of infor mation for
hear ing aid and
cochlear implant
patients who are
looking for phones
that they can use. Because hearing aids and
cochlear implants have to work together
with phones in close proximity, audiologists need to understand the interaction
between them and what laws govern that
interaction.
A
Landline Telephones
All landline phones (phones plugged
into a jack in the wall) manufactured after
1989 have to comply with the Hearing Aid
Compatibility (HAC) Act. The FCC’s
technical standard for HAC is codified at
47.C.R.R. Sec. 68.316. Inclusion of a coil
in the phone handset enables someone
with a telecoil-equipped* hearing aid to
pick up sound directly from the phone
cutting out background noise, eliminating
feedback and giving a direct feed into their
hearing aid from the phone.The law also
requires HAC phones in 100 percent of
hotel guest rooms. Coin and credit card
operated phones, and emergency phones
where people may be isolated such as
elevators, tunnels, highways and workplace
common areas must all be HAC.
In addition, phones in hospitals, residential
health care facilities for senior citizens
and convalescent homes must be HAC
compliant.
Starting in January 2001, the same law
required landline phones to incorporate
volume control as well as hearing aid compatibility.Volume control is a very important feature for people with hearing loss.
Even people with normal hearing turn to
the volume control in noisy settings.The
FCC regulation states that the volume control should provide a minimum of 12dB
and a maximum of 18dB of gain.
Telephones with more than 18dB of gain
must reset to a nominal setting after being
returned to the on-hook state to protect
hearing individuals who may use the same
phones. Though there is no requirement
for cell phones to have volume control
most of them do but usually not strong
enough.
Cordless Telephones
Cordless phones are considered landline
and are also covered by the HAC Act.
Originally these phones were 900 MHz
analog and were fully usable with hearing
aids and cochlear implants.That was until
a few years ago when phone incorporated
digital technology.The evolution of cordless phones to digital 2.4 and 5.8 GHz
resulted in audible interference when held
near a hearing aid or a cochlear implant,
similar to the problem with cell phones.
With urging from consumers, in 2004, the
key cordless phone manufacturers and the
Telecommunications Industry Association
(TIA) (www.tiaonline.org) formed a
working group to identify the problem
and to find a solution. The outcome was
the development of a standard,TIA 1083,
that reduces the interference. Currently,
not all digital cordless phones are HAC but
to help consumers find a HAC cordless
phone there will be a logo on the packaging.The good news is that most of the key
cordless phone manufacturers have committed to making 100 percent of their
phones compliant by 2008.
Cellular Phones
Although the HAC Act applies to all
landline phones, digital wireless (cell)
phones were originally exempt from the
FCC HAC regulations.When they passed
the law in 1988, cell phones were relatively new and considered a luxury item.
Breakthrough Legislation
More than 10 years ago it became apparent that some cell phones caused interference,a buzz,when used with some hearing
aids and cochlear implants. Consumers, led
by Hearing Loss Association of America
(HLAA), advocated getting the FCC
exemption for wireless phones lifted. It
was inconceivable to us that such a huge
group of people, 6.2 million hearing aid
and 35,000 cochlear implant users, be left
out of the telecommunications revolution
happening in the country. It was critical
that they be able to use cell phones that
were no longer a luxury but becoming the
way that America communicated. After
years of working with wireless manufacturers, service providers and the FCC,
many cell phones on the market today are
able to be used successfully by both hearing aid wearers and cochlear implant wearers on both microphone and telecoil
setting.
In 2003, the FCC partially lifted the
exemption for cell phones from the HAC
Act and required a percentage of cell
More than 10 years ago it became
apparent that some cell phones
caused interference, a buzz,
when used with some hearing
aids and cochlear implants.
Consumers, led by Hearing Loss
Association of America (HLAA),
advocated getting the FCC
exemption for wireless phones
lifted. It was inconceivable to us
that such a huge group of people,
6.2 million hearing aid and
35,000 cochlear implant users,
be left out of the telecommunications revolution happening in
the country.
phones to be hearing aid compatible for
use on microphone and telecoil settings.
Consumers should look for ANSI C63.19
ratings that are posted on the packaging
and on the information cards alongside
the phones on display in the stores.The ratings are M3 or M4 for microphone use and
T3 or T4 for telecoil use—the higher the
number, the better the performance of the
phone with a hearing aid or cochlear
implant. FCC regulations also state that consumers must be able to test live phones in the
store before purchasing.
Immunity Level of Hearing Aids
Hearing aids are also now labeled as well
as phones.A factor in successful interaction
between phone and hearing aid is the
immunity level of the hearing aid to interference from other electronic sources.
Eighty percent of hearing aids today have
19
Feature Hearing Aid Compatible Phones
at least M2 immunity levels and some as
high as M4. The immunity level of the
hearing aid is important information to
share with a consumer when they want to
shop for a cell phone. This information
can be found in the product information
manual or by calling the hearing aid manufacturer.The ANSI C63.19 standard was
developed taking into account hearing aid
immunity and interference rating levels of
retired, new technologies appear that are
not hearing aid compatible like the latest
addition of the Apple iPhone. Unfortunately, Apple did not manufacture the
iPhone from the earliest design stage to be
hearing aid compatible, so now Apple will
have to redesign it to make it work for
hearing aid and cochlear implant users.
Several different groups with disabilities
already have filed informal complaints with
Several different groups with disabilities already have
filed informal complaints with the FCC against Apple for
its lack of accessibility. Audiologists should know that
phone/hearing aid/cochlear implant use
equation that the advice to your patients
should still be “try before you buy.”For this
reason, the FCC regulation for in-store
testing is so important. However, keep
these key factors in mind when shopping.
Factors impacting successful cell phone use on
the hearing aid side include:
• Degree and configuration of hearing
loss
• Immunity level of hearing aid/cochlear
implant
• Type of hearing aid/cochlear implant
• Preference for use of telecoil or microphone setting
complaints help to initiate change and should urge their
Factors impacting successful cell phone use on the
cell phone side include:
clients to file informal complaints with the FCC when they
• Style of phone – “Flip” phones have
less interference than “candy bar”
phones
find technology is not accessible to them.
the phone. Adding the two numbers
together, cell phone rating and hearing aid
rating, can give the consumer more information.A total of 5 is the minimum level
for being able to use the phone.
Theoretically a hearing aid with an immunity level of M2 should work fine with a
phone rated M3 or T3 and above. And, a
hearing aid with a rating of M4 should
work even better with the same phone
rated an M3 or T3.
Staying Ahead of the Trends
The wireless industry moves at such a
rapid pace that it is not easy to keep up with
all the latest phones and innovations. But,
at least if audiologists know the standards
and laws governing phones and where to
search the regulations, then they will be in
a position to make recommendations to
their clients.They should also know where
information resources can be found. For
example, HAC handsets are posted on the
Web sites of the manufacturers and service
providers and other third-party sites. (See
sidebar for more information)
Consumers can no longer, nor do they
need to, rely on analog cell phones. As of
midnight on Feb. 18, 2008, cellular telephone companies will no longer provide
analog service. As old technologies are
20
the FCC against Apple for its lack of accessibility. Audiologists should know that
complaints help to initiate change and
should urge their clients to file informal
complaints with the FCC when they find
technology is not accessible to them. For
information on how to file an FCC
complaint go to www.fcc.gov/cgb/
complaints.html.
Additional Legislation
Two additional laws cover all phones
including Section 255 of the
Telecommunications Act of 1996 and
Section 508 of the Rehabilitation Act.
Section 255 requires universal design of
telecommunications products and services to ensure both accessibility and usability by people with hearing loss if the design
is readily achievable. Section 508 applies to
Federal government procurement of technology used by Federal employees and customers. These laws are to ensure that
people with hearing loss have equal access
to the phone systems, and electronic and
information technology currently in use
worldwide so that they can work and participate fully.
Talking to Your Patients
There are so many variables in the tele-
• Size of screen – The larger the screen
the harder to reduce the interference
• Material of case – Metal Casing is harder to shield
• The operating system – AT&T and
TMobile phones that run on GSM
offer less choices of reduced interference phones than Sprint/Nextel and
Verizon phones that run on CDMA
and iDen.
Advocating for You
HLAA continues to work closely with
the telecommunications industry and the
FCC to ensure that new phone technologies that are introduced will be accessible.
Our efforts have already paid off as there
are many phones available today that hearing aid and cochlear implant users find
work well for them.
*Some audiologists are not convinced of the
telecoils effectiveness and neglect to suggest them
as an option. A 1994 survey conducted when
HLAA was Self Help for Hard of Hearing
People (SHHH) asked people if they could
understand speech comfortably on the telephone.
For people with severe hearing loss, comfortable
use of the telephones was 2.6 more times likely
among telecoil users, and for those with severe to
profound hearing loss, three times more. Of note
Hearing Aid Compatible Phones Feature
is that in the latest HLAA member survey conducted in 2005, 80 percent of the respondents
said that they had a telecoil in their hearing aid.
And, in an earlier online survey 57 percent said
they use the telecoil setting with their cell phone.
For more information on hearing aid
compatibility laws, Brenda Battat may be
reached at [email protected]. ■
Laws that Mandate Hearing Aid Compatible Telephones
Hearing Aid Compatibility Act of 1989
www.fcc.gov/cgb/consumerfacts/hac.html
All landline and a percentage of digital wireless phones must be compatible with
hearing aids
Section 255 of the Telecommunications Act
www.fcc.gov/cgb/dro/section255.html
Section 255 requires companies that manufacture and provide telecommunications
products and services to address the needs of people with disabilities at the time
that they design, develop and fabricate those products and services.
(Currently under review by the Access Board)
Section 508 of the Rehabilitation Act
www.access-board.gov/508.htm
Electronic, telecommunications and information technology that is procured,
developed, used and maintained by the Federal government must be accessible to
federal employees and customers.
(Currently under review by the Access Board)
How to file a complaint with the
FCC about inaccessible telecommunication products and services –
www.fcc.gov/cgb/
complaints.html
Other Resources
Hearing Loss Association of America
www.hearingloss.org
FAQ brochure on HAC cell phones
may be downloaded from
http://www.hearingloss.org/advocacy/telecomm.asp
Technology Access Program Gallaudet University
http://tap.gallaudet.edu/Voice/
Update ADA
Changing of the Guard
welcomes its newest Board
members for the 2008 year.
David Berkey,Au.D., will serve as the new
ADA president. Larry Engelmann, Au.D.,
is the Immediate Past President, and Craig
Johnson, Au.D. completed his term as
Immediate Past President and has moved
off the Board
The following individuals are starting
new ter ms in 2008: Charles Stone,
President-Elect; and Susan Parr, DirectorAt-Large. C. Joseph Hibbert has finished
his term as Director-At-Large and moved
off the Board for 2008.
ADA
Save the Date!
ADA will be hosting two big events in
2008. Mark your calendars to join for the
following dates:
2008 ADA Spring Summit
Tuesday,April 1, 2008
Charlotte, N.C.
The Spring Summit will be an opportunity
for ADA members to come face-to-face
and brainstorm on the state of the association and future plans.The day-long ADA
Summit meeting will discuss everything
from the 20th anniversary of the Au.D.
and what “ownership” means to the association and members.
2008 ADA Convention
November 6-8, 2008
GreenValley Ranch Resort in Henderson,
Nev. (outside of Las Vegas)
CTIA the Wireless Association
www.accesswireless.org
FAQ Brochures on Hearing Aid Compatibility with Wireless Phones may be
requested free of charge from Lori McGarry at CTIA.
[email protected]
www.phonescoop.com (show all options)
Wireless industry manufacturers and service provider’s Web sites list HAC
handsets.
21
22
Feature
udiologists in each state constantly battle with issues of
licensure. Licensure bills and
laws are complex in that the
individuals and the varying
groups in each state need to agree on all
parts of the language and proposed changes
for the bills and/or laws to be put into
action.Two states,Arizona and Maryland,
describe some of the challenges and barriers faced during this arduous process.
A new Arizona licensure bill was passed
in spring 2007 and took effect 90 days
after the end of that legislature session.The
information on Arizona’s process, detailed
below, was provided by Robert Scharber,
Au.D., and Georgine Ray, Au.D,. two
members of the ArSHA (Arizona SpeechLanguage-Hearing Association) task force
charged with the bill’s review.
In addition, a new licensure law took
effect in Maryland, Oct. 1, 2007. Sharon
Sorensen,Au.D., provided information on
Maryland’s licensure process.
A
Background
Arizona: Arizona took action to update
its audiology licensure law primarily
because academic programs were changing
and there was no language to allow for
licensing Doctors of Audiology.The original licensure intent was multifaceted:
• to review provisional licensure and
allow those graduating with the Au.D.
degree to use the title of “doctor,”along
with appropriate descriptors. Until this
point, the title of “doctor” was reserved
only for physicians.
• to waive the Hearing Aid exam for all
audiologists
• to address state reciprocity in light of
the Au.D. degree
• to address the lack of input by the
Licensure Advisory Committee in
responding to complaints by audiologists,
hearing aid dispensers and consumers
• to address the definition of an audiology assistant
• to update CEU requirements to 10
and limit the number of hours allowed
as part of manufacturer seminars to less
than half of the total
• to address and include the concept of
telehealth.
Maryland: In 2005, a committee was
formed to work on updating the state
licensure law.Otolaryngologists were invited to participate, but declined.
• Proposed legislation in 2006 failed
because otolaryngologists objected to
the requirement of a doctorate as the
entry-level degree.
• They also objected to audiologists
being called “doctor” and the word
“diagnose” in the scope of practice for
audiologists and speech pathologists.
Sticking Points:
Arizona: Opposition to elements of
Arizona’s proposed licensure law changes
came from two unexpected groups.
• One of Arizona’s state universities
objected to proposed licensure language that referred to applicants
obtaining a doctoral degree from a
regionally accredited program over
questions about what constituted an
accredited program.The bill was actually pulled at the eleventh hour over
this sticking point, but the issue was
eventually resolved after much discussion and debate.
• Though originally in favor of the bill,
the Arizona Commission for the Deaf
and the Hard of Hearing (ACDHH)
ultimately lobbied against it because
the Arizona state audiology organization remained neutral over an ACDHH bill mandating that all hearing aid
patients be counseled, and sign a form,
about the benefits of telecoil. The
ACDHH also lobbied for a return of
master’s level programs under the pretense of giving consumers more choice
among practitioners and allowing them
to find more affordable options. On
this sticking point,Arizona hearing aid
dealers were in agreement with the
audiology community, and actually
opposed the telecoil bill rather than
simply staying neutral.
Maryland: In 2007, otolaryngologists
renewed their objection to the inclusion
of the word “diagnose” in the scope of
practice for audiologists and speech
pathologists.
Successes:
Arizona:The Arizona bill was passed in
spring 2007, after two years of work, with
little revision. Hearing aid dealers who in
the past had blocked efforts to make
licensure changes offered little resistance to
this bill.
Mar yland: Leg islation passed in
Maryland requiring a doctorate as the
mandated entry-level degree.
Compromises:
Arizona: Several compromises were
made along the way as the Arizona licensure bill moved toward passage.
• The inclusion of a definition for audiology assistant was dropped due to its
complexity, as well as time concerns
over reaching a clear consensus on this
topic.
• The concept of telehealth was also
dropped as the bill became focused on
fewer issues.
• The hearing aid exam, which in the
original bill intended waivers for all
audiologists, was eventually waived
only for those audiologists holding the
Au.D. degree.
Maryland: The updated wording for
the scope of practice in audiology and
speech pathology did not pass into 2007
legislation. It was the opinion of the counsel for the attorney general’s office that the
changed wording recommendation,
including the word “diagnosis,” did not
increase the current scope of practice for
audiologists and speech pathologists.
Remaining Hot Topics:
Arizona: Several topics still loom largely on the horizon.
• The Arizona Hearing Aid Society has
proposed, and had accepted into draft
revisions, a name change to the
Hear ing Healthcare Providers of
Arizona.
• The term “audioprosthologist” has
found a resurgence among hearing aid
dealers. ■
23
ADA My Life Is…
providing
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Nancy N. Green, Au.D.
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David P. Goldst
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of Health Sciences.
sity
iver
Un
l
Stil
.
A.T
and adjunct professor at
My Life Is…
24
Nancy Green receives
the
second annual David
P.
Goldstein Outstanding
Audiologist Award at
the
2006 ADA Convention.
Convention 2007 Wrap Up ADA
Q&A
New ADA President David A. Berkey, Au.D.
Congratulations on a successful convention
in Orlando. How do you think the conference was received by the members?
Thank you, Dr. Gilliom. I had quite a
number of members and exhibitors comment on the exceptional quality of the courses and exhibit hall,and just as importantly,on
the overall good feeling and high energy
apparent at the meeting. There was wonderful interaction between younger and older
members,mid-career members and students
throughout the event. And for the first time
in a while, our opening night Pool Party ran
past closing time with standing room only!
Having completed the convention, what
pearls of wisdom can you pass on to the next
convention chair?
My greatest asset was a hard-working program committee that really gave their best to
find compelling topics and dynamic instructors that would provide content relevant to
practicing audiologists, particularly those in
Private Practice. Our President-Elect, Dr.
Charlie Stone, is the 2008 Convention
Chair,and he was one of our program committee members last year as well, so the
wheels are already pretty-well greased and he
is well on his way,having selected most of his
committee. He is no stranger to ADA members or to our exhibitors,and with his experience probably does not need any “pearls”
from me! (He could probably teach me a
thing or two...)
Now you have a new position: President of
the Academy of Doctors of Audiology. What
are some of your visions for 2008?
As I stated in my address to the membership at our annual meeting in Orlando, my
primary focus will be strengthening the
Community within ADA and getting back
to the grass roots feel we had in the early
days of this organization. To do that we need
our founding fathers (and mothers) to transmit that culture to younger members in
different career stages. I am currently working on several projects designed to connect
members with other members,so that there
is a true support network for those with
needs for their practices, and those who are
considering some form of private practice.
Our main initiative going forward is the
ADA Vision 2020, which seeks to provide
the fuel to migrate audiology to a profession
where the audiologist-owned practice is the
rule,not the exception. Our whitepaper on
this Vision outlines the many benefits to
current and future audiologists,the training
programs,and the patients we serve. During
the year we will be developing an action
plan through dialogue with ADA members
(as well as stakeholders outside our organization) to implement the various recommendations. We expect, as a collateral
benefit of this project,that we will be developing formal strategies and models that will
assist all who want to transition in to,or out
of, ownership in an audiology practice.
Both the Vision 2020 and the
Community-building can, and will, work
hand-in-hand to strengthen our organization and provide personalized resources
and benefits for practicing audiologists that
simply cannot be found in a much larger
organization.
Tell me a little about your Board of
Directors.
I have a great Board of Directors to work
with! Our newest member,Dr.Susan Parr,
brings a lot of organizational experience
and an interest in advocacy issues. Dr.
Charlie Stone, our President-Elect and
owner of ESCO, rejoins us after several
years away from the Board, and has
arranged his work life such that he will
have a good deal of time to devote just to
ADA activities. Continuing on the Board
are our Treasurer, Dr.Tabitha Parent-Buck,
our Secretary, Dr. Susan Williamson, and
our members-at-large Dr. Gail Brenner
and Dr. Gretchen Syfert. Finally, our
immediate Past-President, Dr. Larry
Engelmann, may set a record for the most
active Past-President we’ve had, if my email Inbox inbox is any indication. All of
these continuing directors have given tirelessly to the organization and are ready to
“keep on movin’” in 2008! ■
25
26
27
ADA Professional Update
Professional Update
AAA Honors, ESCO/AFA Support Au.D. Student Education, AFA Awards $9K in
Scholarships to Doctor of Audiology Students, HLAA and the Hearing Aid Tax Credit
Bill, Upcoming Events
AAA Update
Academy Announces New
Director of Communications
and New Director of
Reimbursement
The American Academy of
Audiology announce the selection of Amy Miedema as
Director of Communications and
Debra Abel as the Director of
Reimbursement.
Amy Miedema will manage the Academy’s publications,
to include Audiology Today, the
Journal of American Academy of
Audiology, books, brochures and
multimedia, as well as the Web
site and public relations campaigns (Turn It to the Left) and
communication efforts.
Debra Abel, Au.D, will
manage the overall strategic and
programmatic functions related
to reimbursement, coding and
quality measures, including the
development of products and
services in this area. In addition,
she will develop and implement
specific initiatives aligned with
the Academy’s strategic advocacy plan.As part of her duties,Dr.
Abel will also maintain relationships with key personnel of the
Centers for Medicare and
Medicaid Services (CMS), and
other federal agencies, industry
and allied organizations.
As a new addition to the
Academy staff,Dr.Abel will step
down from her position as an
at-large board member. The
28
Board of Directors has appointed Erin L.Miller,Au.D,to complete Dr. Abel’s term on the
board.Dr.Miller is currently the
coordinator of hearing aid dispensary and clinical preceptor,at
the University of Akron, Ohio.
AAA Convention
AudiologyNow! Awarded
One of the Fastest Growing
Tradeshows
AudiologyNOW! has been
awarded one of the fastest 50
growing association tradeshows,
according to TradeshowWeek.The
2007 Fastest 50 Tradeshows are
based on total net square footage
growth and the percentage of
growth from 2004 to 2006.
This award is a great accomplishment and a fitting milestone
achieved in conjunction with
the Academy’s 20th Anniversary.
AudiologyNOW! was honored
at Tradeshow Week’s Fastest 50
black tie gala in Atlanta, Ga.,
Nov. 3-4, 2007. Executive
Director,Cheryl Kreider Carey,
CAE, and Director of
Exposition, Sabina Timlin,
accepted the award on behalf of
the Academy.
AudiologyNOW! has approximately 200+ exhibitors,6500+
attendees,180+ educational sessions and an excess of 100,000
net square feet of floor space.
Exhibitors represent for-profit
organizations and individuals
who derive revenue from the
commercialization or utilization
of hearing and listening products, services and technologies.
For more information on the
Academy, visit our Web site:
www.audiology.org.
ABA Update
Dr. Marion Downs to Serve
as Honorary Chair for
Pediatric Audiology Initiative
The American Board of
Audiology™ (ABA) announces
that world-renowned audiologist, Dr. Marion Downs, will
serve as the Honorary Chair of
the ABA Pediatric Audiology
Specialty Certification initiative.
Dr. Downs has advocated for
universal newborn hearing
screening for more than 50 years
and her commitment to this
cause has ensured that millions of
infants and children are now
identified with hearing loss during critical developmental years.
Dr. Downs’ longtime colleague, Jerry Northern, Ph.D.,
recently announced her appointment at a dinner party in
Washington,D.C.,that celebrated Dr. Downs’ receipt of the
United States Department of
Health and Human Services
Highest Recognition Award.Dr.
Downs celebrated her award and
appointment with three generations of her family and her colleagues from the American
Academy of Audiology, the
American Academy of Audiology Foundation, the ABA and
the Marion Downs Hearing
Center of Colorado.
Dr. Downs stated, “I am
thrilled to serve as the Honorary
Chair of the ABA Pediatric
Audiology Specialty Certifi-
Professional
Update
cation. Pediatric audiology and
newborn hearing screening have
been the focus of my professional life and this initiative is
another means to see that excellent hearing health care is available to infants and children with
hearing impairment.”
James Beauchamp,Au.D., the
ABA board member who is
spearheading the initiative
together with a committee of
luminaries in the field, added,
“The ABA is delighted that
Marion Downs, who has done
so much to ensure that infants
receive screening for hearing
impairment, is now lending her
invaluable support to this next
critical step in affording appropriate hearing health care to
infants and children.”
Established in 1999, the
American Board of Audiology™ (ABA) is a national credentialing board that confers
Board Certification in Audiology to those audiologists whose
knowledge base and ethical
practices are consistent with professionally established standards
and who continue to enhance
their professional knowledge
through ongoing professional
education.The ABA also administers a specialty certification program in cochlear implants
established to help meet the
growing need for audiologists
with experience in this specialized area of audiology.To learn
more about the ABA, visit our
Professional Update ADA
Web site at www.americanboardofaudiology.org.
ACAE Update
Accreditation Commission
for Audiology Education
(ACAE)
The Accreditation Commission for Audiology Education
(ACAE) is an accreditation
agency that evaluates academic
programs in audiology at the
Au.D. level.This system is critical because peer-evaluators,
trained by the ACAE, assess
whether a program provides a
curriculum that assures audiologists such as yourselves,i.e.,communities of interest, and the
public that it will produce its
future competent and technologically sophisticated audiologists. These peer-evaluators
examine whether a program
complies with the rigorous educational Standards established by
the ACAE.The critical aspect of
ACAE is that it is devoted exclusively to audiology at the Au.D
level.Thus, the ACAE Board of
Directors approves educational
Standards that are totally responsive to the educational needs of
contemporary audiologists.
ACAE has now produced an
accreditation agency and technological system that is innovative and unique among
professions throughout the
United States. It has completed
a beta-system test with the cooperation of two universities and
the test has been an invaluable
experience.It has accredited one
university thus far and has just
completed the on-site visit of
the second.
At the conclusion of a busy
past 2007 summer and fall,
• ACAE officially launched its
accreditation program and
developed a Web site of its own.
Please visit our Web site at
www.acaeaccred.org to see
and hear the latest ongoing news
and happenings.
• ACAE submitted its application for membership to the
Association for Specialized and
Professional Accreditors (ASPA)
in July and was approved at the
ASPA fall meeting in Louisville,
Ky..ASPA is a key advocacy and
networking organization for
accreditors.
•ACAE has at least five additional academic programs in the
pipeline for an accreditation
process.
• ACAE will announce,in early 2008, a Call for Nominations
for future peer-evaluators or site
team visitors.
• AND…thanks to the
American Academy of Audiology (AAA), the ACAE has a
new office site in Washington. It
is in the process of moving into
the new Capitol Hill Office site
of the AAA at 312 Massachusetts
Avenue, NE. At the same time,
ACAE will have a new
Administrative Assistant.
Please feel free to contact us at
[email protected]’re
happy to hear your thoughts and
suggestions!
AFA Update
AFA Reveals New Mission,
Raises More Than $55,000
At the recent Academy of
Doctors of Audiology (ADA)
convention, the Audiology
Foundation of America (AFA)
revealed a new theme,“Launching Professionals into Practice,”
along with a new mission – both
the result of facilitated summer
meetings that looked at the future
of the audiology profession and its
role in the ever-changing health
care environment.
In line with its new mission,
the AFA will now concentrate
efforts on empowering audiologists to be independent and
autonomous practitioners by
supporting their educational
preparation,professional practice
and leadership development.
“Au.D. graduates are not
always prepared for independent practice or for roles of equal
value on health care teams,”said
AFA Executive Director Susan
Paarlberg. “Many need additional resources to provide the
full spectrum of expert patient
care.Faculty interests in research
specialties often aim students
away from mainstream audiology patient problems,and we plan
to launch a sea change of new
attitudes and resources to help
audiologists succeed as health
care practitioners in our modern
competitive world.”
In support of its new mission,
the AFA also raised more than
$55,000 at the ADA convention
through combined efforts in
both its annual AFA Auction and
Golf Tournament. The AFA
Auction garnered a net income
of almost $40,000, including
nearly $10,000 directed for student scholarships.
AFA held this year’s golf tournament at the Grande Pines Golf
Club and brought in more than
$17,000. Twelve sponsors,
including Audiogy Group,Berge
Hearing, Bernafon, ESCO,The
Gillum Group, Marcon,
MicroTech, Oticon, ReSound,
Sonic Innovations,Vivatone and
Widex,supported the golf tournament through hole sponsorships, lunch, photography,
transportation, beverage carts
and the 19th hole party.
To cap off its ADA activities,
the AFA, with financial support
from ReSound and Widex,
brought 30 Au.D. students to
ADA to participate in its annual
Student Mentoring Program.
This program allows students to
gain broad exposure to realworld audiology,learn from successful practitioners and network
with future colleagues.
AFA Honors New Au.D.s
with Professional
Leadership Award
During August graduation
events at the Arizona School of
Health Sciences, Kirsten Vesey,
Au.D.,and Bernard Lipin,Au.D.,
both received AFA Professional
Leadership Awards.These awards
honor graduating Au.D.students
who have exhibited a positive
attitude and strong work ethic
throughout their Au.D.program,
and who have displayed an
involvement in professional
activities and dedication to public service that promotes the profession and patient care.
Dr.Vesey was recognized for
her exceptional leadership, and
her professional dedication and
service to NAFDA and the U.S.
military. During her Au.D. program, Dr.Vesey provided three
years of dedicated service to
NAFDA (the National Association of Future Doctors of
Audiology), most recently serving as secretary for the national
board. In addition, Dr. Vesey
completed her fourth-year
externship at the National Naval
Medical Center in Bethesda,
Md., and will continue to provide military audiology services
as a commissioned officer.
Dr. Lipin was honored for his
years of successful practice
topped off by his determination
to represent the finest qualities of
professionalism in the completion of his Au.D. degree. Dr.
Lipin, who served as a military
29
ADA Professional Update
musician and speech therapist
before discovering audiology,still
sees patients as a private practitioner in Connecticut. He has
been a member of ADA since its
early years, and is a life member
of AAA and a Paul Harris Fellow
of Rotary Club. As a further
commitment to lifelong learning, he also recently started taking a course in German.
AFA Awards Distance
Education Scholarships
to Practitioners
The AFA has announced
nine final winners in its
Practitioner Scholarship series.
Each recipient, chosen by a
selection committee, won
$1,000 to support distance
Au.D. education. Scholarship
funding was provided through
donations to the AFA in support of its mission to transition
the profession to the Au.D.
The nine final scholarship
winners are:
Heidi Daley – a schoolbased audiologist and director of
audiology for the Southeast
Kansas Education Service
Center in Girard, Kan.
Nonalee Gardner – a
school-based audiologist currently serving students through
the Grant Wood Area Education
Agency in Cedar Rapids, Iowa.
Rachelle Groulx – a Toronto
audiologist who currently works
with geriatric patients at Baycrest
Centre for Geriatric Care and
pediatric patients at MD
Hearing, Speech and Learning
Centre.
Carolyn Nilsen – an audiologist for more than 20 years and
currently employed by the High
Desert Educational Service
District in Bend, Ore.
Diana van Deusen – an
audiologist for 25 years who is
employed by St. Paul Public
Schools in St. Paul, Minn.
Frankie Mickelson – the
30
first public school educational
audiologist in the state of
Maryland and employed for
more than 30 years by Prince
George’s County Public
Schools.
Beatrice Braun – a 15-year
California audiologist who owns
the Auditory Processing Center
of Pasadena and is also employed
by the Ventura County Office
of Education.
Ann Gear – an audiologist
for more than 20 years and currently employed by the Special
Education District of McHenry
County in Woodstock,Ill.She is
earning her Au.D. from ASHS.
Colleen Armgardt – an
audiologist for more than 25
years who has been employed
since 1980 as a pediatric and
educational audiologist in the
Special Education District of
Lake County in Gages Lake,Ill..
AFA/Widex Award Au.D.
Scholarship
California audiologist Susan
Clark has won the second of
three 2007 AFA postcard scholarships to pursue Au.D. distance
education.Widex sponsored the
postcard and Clark’s $1,000
scholarship.
Clark is a school-based audiologist for ABC Unified School
District in Cerritos, Calif., and
will soon begin the distance
education Au.D. program at the
Arizona School of Health
Sciences.
HIA Update
Constituents Thank Rep. Van
Hollen for His Support of
Hearing Aid Tax Credit Bill
A capacity crowd of more
than 120 Marylanders from the
8th Congressional District
(Montgomery County) met
with Rep.ChrisVan Hollen (DMD) to thank him for his original co-sponsorship of H.R.
2329, the Hearing Aid Tax
Credit. Rep. Van Hollen is a
member of the House Ways and
Means Committee that must
approve all tax legislation.
The program featured testimonials by Marylanders who
described the importance of
hearing aids to their daily lives
and the financial problems
caused by the lack of financial
assistance when seeking hearing
aid treatment. Meredith Isola
of Kensington, Md., described
the importance of hearing aids
to her young son who was born
with a hearing loss; Jenny
Cheng,a young woman starting
a professional career in
Washington, D.C., praised
advances in hearing aid technology while expressing frustration
with the cost of treatment; and
Lise Hamlin of Rockville, Md.,
focused on how hearing aids
have enabled her to continue to
work and lead a productive life.
Hearing aid wearer Malika
Jalloh-Jamboria of Clarksburg,
Md., recited the Pledge of
Allegiance to open the program.
Rep.Van Hollen addressed the
crowd and noted that while
Congress has appropriated funds
to support infant hearing screening, the lack of financial assistance once a hearing loss is
identified causes serious problems for many low income people. This lack of funding is
especially problematic for children who remain untreated and
who,as a result,face serious limitations to their ability to learn
and interact with others.
H.R. 2329 provides for a
$500 tax credit for a hearing aid
($1,000 if two devices are needed) for those age 55 and older
and for children or other
dependents.The bill would help
to offset the average cost of
hearing aid treatment (approximately $1,800).Medicare does
not cover hearing aids, nor do
most insurance policies.The bill
is structured this way to minimize the financial impact on
the federal budget. As of
October 15, sixty Representatives have co-sponsored the
bill. Seven Senators have cosponsored S. 1410, identical
Senate legislation.
The event was organized by
Rep. Van Hollen’s constituents
who are active in the Maryland
affiliates of the Hearing Loss
Association of America and the
Alexander Graham Bell
Association for the Deaf and
Hard of Hearing.The Hearing
Industries Association sponsored
the event.
ILAA Update
ILAA
The 2008 Illinois Academy of
Audiology Convention will be
here before we know it,so mark
your calendars! The convention
will begin on the morning of
Wednesday, Jan. 23, 2008, with
pre-convention opportunities
available and end in the late
afternoon of Friday, Jan, 25,
2007.The meeting will be at a
new location, the Drake Hotel,
in downtown Chicago.
For more information, please
visit our Web site at www.ilaudiology.org. Registration will
begin in December 2007. ■
If your state or organization has a
conference that you would like listed
in Feedback, please e-mail the
editor-in-chief, N. Gilliom Ph.D. at
[email protected].
Academy of Doctors of Audiology®
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Chicago, IL 60611
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