Tinnitus Cost

Will my insurance cover the Neuromonics Tinnitus Treatment?

• Because the Neuromonics Tinnitus Treatment is unlike anything previously available, it may not be specifically included or excluded from your plan. You or your clinician’s office may need to work with your insurance company to clarify that this is not a hearing aid, masker, noise generator or other such device.

Can I use a Medical Savings Account?

• Yes. A medical health savings account is a viable alternative.

How can I improve my chances of getting coverage?

• Many patients find they are their own best advocate when it comes to seeking reimbursement for the cost of treatment. You can help your clinician’s office make sure that the treatment is coded and described accurately by familiarizing yourself with the process below. For complete details, please request a copy of our Reimbursement Guide.

Why can’t my clinician’s office just tell me if I’m covered or not?

• Coverage varies. It is your particular benefit plan—not the insurance carrier or its general coverage policies—that will determine your coverage. For example, your clinician will need to demonstrate the medical necessity of treatment.
• Your clinician’s office should submit a predetermination or preauthorization of benefits as soon as you are identified as a candidate for the Neuromonics Tinnitus Treatment.

Below is a general description of the steps involved in predetermination or preauthorization.

For complete details, please request a copy of our Reimbursement Guide.

Step 1: Candidate is identified for Neuromonics Tinnitus Treatment and Oasis™ Device.

Step 2: Provider obtains copy of patient’s insurance card and all applicable insurance information.

Step 3: In the case of non-coverage, patient is asked to sign Waiver of Financial Liability.

Step 4: Provider contacts patient’s insurance company to verify benefits and  predetermination/preauthorization requirements including:

• Phone, fax, email and/or overnight street address

• Person to whose attention the packet should be sent

• List of materials required to obtain predetermination/preauthorization

Step 5: Provider prepares a predetermination/preauthorization letter (letter of medical necessity). A sample letter is included in the Reimbursement Guide.

Step 6: Provider submits letter and documentation as directed in Step 4.

Step 7: If approved, provider proceeds with scheduling. If denied; begin appeals process.

Step 8: Provider submits properly coded and documented claims.

Step 9: Provider tracks reimbursement; review Explanation of Benefits or EOB for appropriate coverage and payment levels.

Step 10: Provider appeals underpaid or denied claims as necessary.

My claim was denied. What happens now?

• Insurance companies usually have an accepted set of diagnoses and treatments they cover, and relatively new treatments that do not fit into existing formularies can be more likely to be denied at first. Guidance and sample appeal letters are included in the Reimbursement Guide.

You may also want to seek help from your HR department, or from groups such as the American Tinnitus Association.