About a year ago, I decided to become an in-network hearing aid provider for TruHearing. TruHearing is essentially a managed care organization that acts as a middleman between the hearing aid manufacturer and a hearing care provider. Insurance companies contract with these managed care organizations because it helps them control costs of hearing aids and hearing aid-related services to save the insurance company money.
In order for some patients to be able to use their insurance inside of my clinic, if their insurance company contracted through TruHearing, then I had to become an in-network provider for TruHearing. Becoming a provider was super simple. Basically, I just had to be licensed inside of my state, I had to have liability insurance, and then I had to answer a few disclosure questions.
Ultimately, working with TruHearing from a provider perspective was pretty easy. They had some decent options for hearing aids. They had a really neat online portal that I could go on to actually order those devices and process payments. Also, the staff that work at TruHearing were really nice and very helpful in terms of getting insurance benefits verified and getting patients scheduled.
The only problem that I really had with TruHearing is that I couldn’t afford to service those patients because my clinic would lose money every single time a patient came in the door. How it works is that TruHearing will collect payment from either the patient, the insurance company, or a combination of the two. Once they actually pay and they go through their fitting process with their hearing aids, the hearing care provider gets paid a fitting fee.
The amount that TruHearing pays a clinic depends on the level of technology that that provider fits to that patient. So, if a patient only requires a low level of technology, then TruHearing will only issue a very small fitting fee.
These fitting fees aren’t enough to cover the clinic expenses. Additionally, providers of TruHearing are contractually obligated to charge a max of $65 for a follow-up visit, or a max of $250 for an annual service plan. Anything additional to this would be considered a violation of the TruHearing agreement.
From a patient perspective that may seem great. But, from a clinician perspective, if I can’t actually charge what it costs to run my clinic my clinic is either going to go out of business, or I’m going to have to sacrifice my quality of care by dramatically reducing the amount of time that I spend with a TruHearing patient.
You see, quality of care boils down to two main things.
1. I have to be able to recommend the right treatment for a patient based off of their specific needs.
2. I have to be able to provide the very specific services necessary to maximize the performance of those devices, both at the fitting and for all of those follow up visits.
If I don’t have the amount of time necessary to administer those proper procedures, then you’re not going to be getting the highest level of care.
I would love to charge patients really low fees for the services that I provide. However, the simple fact of the matter is that the cost to run a clinic, both from the rent standpoint, the staffing standpoint, utilities, and equipment costs, all of these different things cost money. And it is not cheap to run a clinic, so I can’t charge really, really low fees without running risk of going out of business. It just can’t be done.
Every time a TruHearing patient came through my doors my clinic would be losing money. I could have charged a $250 annual service plan and then restricted the amount of times that a patient came in to my clinic. And then, every single time they came in I could not do the procedures necessary to maximize their performance with those devices.
I’m not comfortable with reducing quality of care. If there’s one thing that I refuse to do, it is to reduce my quality of care in order to maximize profit.
I had to make a tough decision, and that tough decision was to leave TruHearing. I didn’t write this article to try to make you feel sorry for me or to say anything negative about TruHearing. In fact, if you can find a good hearing care provider who works with TruHearing then kudos to you. I just couldn’t afford to be one of them.
TruHearing is a third party managed care program that contracts with insurance companies to control costs. TruHearing negotiates a specific amount of reimbursement from insurance companies combined with some costs being passed on to patients.
Working with TruHearing is relatively easy. They have an interactive website to order devices and verify insurance benefits. They have a good variety of good hearing aids to choose from, and the entire process is streamlined nicely from patient scheduling to hearing aid fitting.
The only problem was, ever time a TruHearing patient came to the clinic, we would lose money. TruHearing only pays a small fitting fee to hearing care providers.
Additionally, TruHearing limits follow-up charges to only $65 per visit or $250 for an annual service plan. This sounds great if you are a patient, but if a clinic can't cover the cost of doing business it will go out of business.
Clinics need to pay rent, staff, utilities, and equipment costs among other expenses. When these costs exceed reimbursement rates from TruHearing, each visit a patient makes increases the risk of a clinic going out of business.
So unless I was willing to significantly reduce time spent with patients and dramatically reduce quality of care, I could not stay a TruHearing Provider.
I don't say this to speak poorly of TruHearing. There may still be good hearing care providers who are a part of the TruHearing network. I just couldn't afford to be one of them.