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Thread: audiologist

  1. #1

    Default audiologist

    AAPC: Back to School
    I am looking for any information anyone can provide me about billing for audiologists. we have added an audiologist to our practice and are getting conflicting answers on how to bill claims for her. She of coarse has an NPI and is contracted with medicare. I guess we are confused with private payers.we are not sure we want to add her to our group contracts because than she'll fall under the terms our physicians fall under which isn't always good for hearing aids. Any suggestions on what any of you do with your audiologists. We are in Florida so advise on those state laws would be most helpful.

  2. #2
    Join Date
    Apr 2007


    I would recommend contacting your private payers and checking to see if you need to bill with their NPI number or your physician's. I am in Ohio and my practice employs 2 audiologists. Only 2-3 private carriers require us to bill services under the audiologist. All the other private carriers want us to bill under the physician. Of course, with Medicare, you must bill audiology services under the audiologists NPI. I hope this helps you somewhat.
    Eileen Roland, CPC
    Stow, OH

  3. #3
    Join Date
    Apr 2007
    Bentonville, Arkansas


    I bill for 6 audiologist in our ENT office. When billing to Medicare, you must bill under the audiologist NPI and not "incidental to" the physician. As far as billing to private payers, I bill hearing tests under the audiologist NPI and not "incidental to." Billing Hearing aids - first call the patients and verify Hearing Aid benefits, if they are a covered benefit; bill the insurance. If they are not a covered benefit, bill the patient. In our office, we ask for a deposit of $500.00 (for one aid) and $1000.00 (two aids) at time of order, when the patient comes back to the office for their "fitting" we require the remaining balance to be paid. However, during our 30 day return policy, the patient is not happy with their hearing aid(s) they are either fitted with a different type of aid or given 1/2 of their deposit back. During the 30 day trial period, hearing aids are not billed to insurance till the patient returns for their 30 day hearing aid recheck.
    I hope this helps.

    Sheri Varner
    St. John's Clinic - ENT
    Springfield, MO

  4. #4


    How do you hve your Audiologist listed with insurance companies? Are they listed as nonpar or do they have there own contracts with private payors.

  5. #5
    Join Date
    Apr 2007
    Bentonville, Arkansas


    The Audiologists are certified & contracted to bill & are billed as primary. I began billing them as primary once they received their NPI & eligiblity date. Do you work for a private office or with a Group?

  6. #6


    I bill for an Audiologist in Ohio. We bill all of her claims out under her as the provider with a few exceptions. Our Ohio Medicaid and a few of the Medicaid HMOs want to see the physicians name rather than hers. Also there is one commercial policy (not the whole company, but one policy under that co.) that requires her to be billed as the Doctor. I would suggest seeing how each company wants your charges billed. 98% of our insurances (Medicare and commercial) do not pay for the hearing aids any how, whether she is contracted or we bill under the Dr.

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