Tuesday, January 28, 2014

"I ATE MY OWNER'S HEARING AID." barked Fluffy.


 You want to know why your dog perks up 
long before you hear someone walking up to the door? 



Dogs hear up to 50,000 to 65,000 cycles per second – humans, just 20,000.

Dogs have 18 or more muscles in their ears allowing them to be mobile.

Dogs hear about 4 times the distance of a humans. 

Dogs hear ultrasonic frequencies like 

dog whistles 

a squeaking mouse or 

whistling hearing aids!

Source
Source




So, remember to open the battery door whenever your hearing aids are not in use,

 so your dog isn't attracted to the high frequency feedback.

Source



Well speaking of dogs, here is Jade my family pet and therapy dog who would never does anything wrong!



Ling's Voice

After about two years of her son’s d/hh of hearing journey began,
 including Auditory Verbal Therapy, Bethany Horn has published,



Ling’s Voice a tool for families and AVTs to provide the children
 with opportunity for sound or word imitation, to test speech detection and
 encourage spontaneous vocalization with use of auditory memory. 


Bethany says, “It’s to assist the kids working so hard to listen and use spoken language!”


You can order your copy at:






Monday, January 27, 2014

UNDERSTANDING INSURANCE PLANS

Source
This article is adapted from © Jennifer Getch, MA CCC-SLP 
www.nwspeechtherapy.com/blog

First, talk to your Audiologist or Auditory-Verbal Therapist to determine which specific codes will be used for billing. You will need to know both the:
• The CPT procedure code(s)  
• ICD-9 diagnosis code(s)

When calling your insurance company to check on benefits for Auditory Rehabilitation, Auditory Verbal Therapy or Auditory Processing Therapy utilize the "cheat sheet" below.


Insurance Terminology


It can be daunting when dealing with insurance companies regarding the health coverage of auditory rehabilitation or auditory-verbal therapy sessions for you or your child. Below are some insurance terms you may come across when dealing with insurance.

Co-pay: People are most familiar with a co-pay. This is the specific amount of money that you pay for certain services. It may be $15 co-pay for a doctors visit, a $25 co-pay for a prescription but either way you know exactly how much you will need to pay and it DOES NOT change based on the cost of the service. You will pay your $15 co-pay whether the doctor charges $300 or $3000 for that service.

Co-insurance: This is the amount you will pay for each service and it is based on a ratio that is set by your plan. If your visit costs $100 and your plans co-insurance ratio is 80/20 then your insurance company will pay $80 and you will pay $20. If the same visit was $1000 then your insurance will pay $800 where you would pay $200. Therefore it DOES NOT stay the same as it is based on what the services cost. (NOTE: It is extremely rare for a health plan to have both a co-pay and a co-insurance that would be due for a particular service, it is usually one or the other.)

Deductible: This is the specified amount of money that you will pay out of pocket BEFORE insurance begins to cover any portion of the charges. It is important to specifically ask if a patients deductible has to be met prior to insurance kicking in as there are many plans that have a deductible, however, the patient does not have to meet the deductible for speech therapy services prior to insurance kicking in.

Maximum out-of-pocket: This is the maximum you will have to pay in a year. It is an accumulation of your deductible, co-pays and co- insurance. After the maximum out-of-pocket has been met then insurance will pay 100% for the remainder of charges.

Prior authorization: Prior authorization is pre-approval from your health insurance plan that the specified service WILL be covered. If your health plan requires prior authorization for a service then it is required for you to obtain this approval BEFORE you have the service done. Otherwise Insurance can deny it even though they may have otherwise covered it. Most health plans have forms on their websites to download, fill out and fax in to get this approval. You will need to send the evaluation report, if available.

CPT code: This is a 5 digit numerical code that is used to describe medical procedures. Common ones for Auditory Rehabilitation are:

CPT code 92626, Evaluation of Auditory Rehabilitation Status, first hour
CPT code 92630, auditory rehabilitation, prelingual hearing loss
CPT code 92633, auditory rehabilitation, postlingual hearing loss

ICD-9 code: This is a coding system used to describe signs, symptoms, conditions, injuries or diseases. (NOTE: ICD-10 will begin in October 2013).

Exclusions: These are specific conditions (ICD-9 codes) not covered by an insurance plan.
Appeal: This is the course of action you can take when coverage of a service has been denied and you would like the insurance company to re-assess in the hopes that they may change their decision and cover the service previously denied.

Allowed amount: This is the amount that an insurance company bases their payment on. It is not necessarily the amount that the provider billed. For instance, the provider may bill $130 for a service however; the insurance company only allows $100 for that service so the co-insurance amount is based on that allowed amount and not the billed amount from the provider.

In-Network: Most insurance plans have different coverage based on whether the provider is "in-network or out-of-network". Co-pays, Co-insurance and deductibles are often lower for in-network providers. To be considered in-network, the provider has to have a contract signed with the insurance company. The downside to this, for a provider, is that this contract often limits the amounts that the provider can charge the insurance company for a particular service and the insurance company does not allow a provider to bill the patient for the amount over what insurance allows.

Out-of-network: Patients will often pay more for co-pays, co-insurance and deductibles when utilizing an out-of-network provider. They will also often incur the additional cost above what the insurances allowed amount is. Let’s say that your insurance allows a
provider to bill $250 for a particular service but that provider normally charges $300 for this service. If your co-pay is $25.00 then you will pay $25.00 in addition to the $50  not allowed by insurance. Especially with the big changes happening with health insurance, many providers choose to be out-of-network providers so that they do not have to take such a big deduction in their reimbursement rates.

Medical Necessity: Many insurance plans will only pay for services that they feel are "medically necessary", this often means that they will require reports from therapists, physicians, etc. and will utilize their own professionals to conduct an evaluation of these reports in determining if there is a medical necessity for the patient to receive the services in question.


Explanation of Benefits (EOB): This is a summary of the billed service where you are able to see what portion was applied to deductible/co-pay/co-insurance, etc. It will also tell you when services are denied and why.

Check Reimbursement Resource Guides such as:
http://apps.advancedbionics.com/cismart/CPTSummary.aspx



 FOR MORE INFORMATION

Insurance Guide for Parents:
http://www.listeningandspokenlanguage.org/Document.aspx?id=228

Reimbursement and coding:
http://www.audrehab.org/6%20Reimbursement%20Panel%20_Abel%20&%20White.pdf
http://www.audiologyonline.com/articles/audiology-cpt-code-changes-for-1001
http://www.asha.org/practice/reimbursement/coding/ar_reimbursement/



Saturday, January 11, 2014

Role Model in the Spotlight - Seahawks Fullback Derrick Coleman

This week I shared this video with some of the children and their parents in my practice. They related to Derrick Coleman's story because of the positive modeling and years of high expectations in our Auditory Verbal Therapy.

https://www.youtube.com/watch?v=u2HD57z4F8E#t=11



What's your vision for your child?


The Power of Positive Thinking by Norman Vincent Peale




Thursday, January 9, 2014

Disney's Access Program

Click HERE for a bloggers post regarding the new Disney's Access Program.


If you are planning a visit can call Guest Information:
 (714) 781-4636 for Disneyland and (407) 824-4321 for Disney World.



Tuesday, January 7, 2014

The Ear Book: An interactive guide to the various parts of the ear.


This interactive guide leads you through the process of hearing
 from the outer ear to the cochlea and inner ear bones,
 and finally to the auditory nerve that sends impulses to the brain for interpretation. 



Just click on each stage to reveal the process and respective conditions in deeper detail.

 Click HERE to view The Ear Book free online 
at the ADVANCE Healthcare Network for Speech-Language and Audiology.



HERE is a free PDF version of this guide.

Monday, January 6, 2014

TJ’s Story: Hearing Challenges & Self-Advocacy

TJ's tells his story of struggling to hear, communicate, and fit in socially. 




TJ's Story is a tool to promote self advocacy for kids 
and to better educate parents, peers and teachers.
Click HERE is a free PDF download   
TJ’s Story booklet with examples of IEP goals  written to Common Core Standards can be purchased at:

Saturday, January 4, 2014

JANUARY : Listening and Spoken Language Calendar


“Children learn language best through enjoyable, natural, meaningful one-to-one interactions with people who are special to them – their parents!” 
Judith Simser, O.Ont., B.Ed., Dip Ed. Deaf, LSLS Cert. AVT

Here is a month's worth of language suggestions that you can incorporate into 
LISTENING and spoken language activities with your child.

Click HERE to download your own printable copy.
 

Today, due to advances in hearing aids and cochlear implant technology, early diagnosis, and support from Auditory Verbal therapists, children who are deaf or hard of hearing can develop listening and spoken language.  

Winter Pinterest Board for Auditory Verbal Therapy

Click Here for listening and spoken language ideas
 for home or in parent centered therapy.

232 PINS!

Friday, January 3, 2014

Tips For Communication With People With Hearing Loss

Source
While conversation comes easily to most people, for those with hearing loss it can be a frustrating, confusing and ultimately alienating experience.

Source

For the person with hearing loss even those that wears hearing aids or cochlear implants, it is important that other participants in the conversation employ helpful communication strategies like the ones listed below.  This will ensure that the person with hearing loss can understand and contribute to the conversation.


TIPS FOR COMMUNICATING WITH PEOPLE WITH HEARING LOSS

            • Position yourself to accommodate the person with hearing loss. Face them directly, in good light and on the same level. If they hear better in one ear, place yourself on that side.

• Do not try to talk to the person from another room. Those who are hard of hearing often need to see the talker to better understand what is being said.

• Speak clearly, slowly and naturally. Enunciate your words!


 • Do not shout or over-exaggerate facial expressions and mouth movements. This can seem to interpreted as rude or  aggressive and will only lead to confusion.

• Keep your hands and other objects away from your face. Hands, food and chewing gum  can make it harder to understand what you are saying.

• Be aware of background noise levels that lead to difficulty for the listener with hearing loss. If possible, conduct the conversation in a quiet area.

• Pay attention to the listener’s facial expressions. Do they look lost or puzzled? Are they just nodding or bluffing when they really are lost in the conversation?

• In a group conversation, take turns speaking. Talking over others if often confusing the listener.

• Get the listener’s attention before addressing them. This can be done with a wave or a polite touch on the arm.


• Remember to state the topic of conversation or when changing the topic so the listener can more easily fill in items misheard. 

• Lastly, do not simply repeat yourself over and over again if the listener does not understand something. Try phrasing the sentence differently, or write it down if necessary.