Visiting the Audiologist is like going to a car dealership?

I’ve read that the Audiologist’s markup on the Hearing Aids is from 300% to 400%. That’s how they make a living. It explains why the cost of some that were demonstrated to me several years ago was $6,500.00. I’m quite new to this, but am an avid DIY-er and quite familiar with the audio spectrum. I have the iCube II and am shopping for the PHONAK Audeo Marvels on the cheap. The nearest Audiologists that I know of are in Grand Forks, ND and that’s 55 miles distant, one way.

There is a similar situation with CPAP machines around here. A sleep clinic want $2400 for them while you can buy the same machine on line for $800. The mark up over the on line price is 200%!

@Sierra said:

There is a similar situation with CPAP machines around here. A sleep clinic want $2400 for them while you can buy the same machine on line for $800. The mark up over the on line price is 200%!

How long does it take them to set them up? Including follow-up.

It can’t be more than 15 minutes (excluding the sleep study) Other than an emailed question or two, I haven’t needed any followup in a year. However, I got mine through an HMO for something like $650.

I tried out 3 audiologists before I found a good one. The first two you could tell had no interest in the field at all. The third was a total gear-head. For me the bad experiences are auto repair places and the dentist.

Traditionally, audiologists do not charge for fitting, checking your ears for blocking caused by wax, adjustments or other services that do not cost them much. They have always done so because they want to keep you coming back until you need new hearing aids. If you bring a pair back that you are having problems with (after the warranty has expired), they usually return them to the manufacturer for repair/replacement, but only after they press hard to get the consumer to replace them with “new technology.”. They do charge a fee for repairs, as they do for making ear molds if you need them. They all sell accessories like devices that stream from your TV or batteries, which are priced out of this world (as are the hearing aids themselves). All of this is driven by the manufacturers, and there are only six companies that control the market. They don’t allow the audiology practice to sell below suggested retail. Because older people buy the bulk of hearing aids (if they have the money), the audiology practices are able to pretty well fleece them. The audiologist can appear to be a kindly person interested only in the welfare of their patients. A few of them are. But that way of doing business is fast going out the window. Sam’s and Costco have really hit the market hard, charging half or less than the traditional audiology practices do. I believe that this revolution will continue to grow, and hearing aids will soon be available at a reasonable price. I have no problem paying for services I might receive, and I believe this will also become a standard practice. I also expect that the practice of running full page ads offering “free” hearing aids to unsuspecting potential customers will stop. It is a hoax after all…

Any evidence for manufacturers not allowing audiologists to sell below “suggested retail?” I’ve seen a lot of variety in pricing.

I’ve worn hearing aids for more than 30 years. Periodically I visit an audiology practice for repairs or ear molds. I am always pushed to buy the new technology. I get them to talk about price and tell them I need to think about it. On three occasions I did need new hearing aids and visited several standard audiology practices. After a hearing test, which they insist on doing, we talk about price. You can never get a price on the phone. I have never seen more than a $150 variation in what they charge taking into account features and benefits. The features are what drive the selling price. And guess what, I don’t see much difference in models from manufacturers. Seems they all come out with the new technology about the same time. Funny how their research always produces innovations at about the same time. No collusion there, right? But as an audiologist you already know this. i no longer buy new HA’s from an audiology practice. I get my audiology report done at a University nearby. (I have to pick up a copy from the Medical Records Dept. I buy on the internet (usually on eBay). I can buy good technology for 1/3 the price with a one-year warranty and a no questions asked policy for up to 90 days. I do go to a standard practice for things like new ear molds, and I am happy to pay for that service.

So, out of curiosity, do you see a practising audiologist or one of the graduate students?

On a similar, but slightly different theme, I have an appointment today with my audi/clinic to finalize my agreement to purchase the Marvel90Rs. I like them, despite all the bluetooth issues (which I hope to resolve), and am ready to sign the contract. Up to this point, the clinic has allowed me to trial an Oticon OPN, Marvel 312s and now the rechargeable units. I have not been charged anything…yet. Last time I was there, they presented a contract to sign, but there were some things that needed to be addressed, and ultimately I was told I didn’t have to sign it until my next visit. So here we are…

My biggest issue is the billing. I am extremely lucky in that I have double insurance – my primary from my employment and my secondary from my partner. I will retire soon and know that this type of coverage will not come my way again, so I want to make the most of it. The clinic originally told me that they were in-network with my primary, but not with my secondary. In both cases, the coverage is the same whether in-network or out of network, with one major difference: an in-network provider cannot charge me for the price difference if what they receive is less than what is denoted on their contract with me. An out of network provider has no such limitation. So hypothetically, if the contract price was $7000, and the clinic is paid $5000 from the insurance companies, they could demand I pay the $2000 difference. I called both my insurance companies to confirm and found that the clinic isn’t an in-network provider for either insurance. The insurance companies have done business with them, but out of network. Still, I like the clinic. What to do?

Well, I’ve drafted an addendum that I believe is fair to both parties and today I will present it. I hope this is well received – we’ll see. I want to be fair to all, but I want to protect myself too. Last week, they tried to fix the out of network issue among some others by writing on the contract, but that got messy and less than professional. It’s difficult to draft that type of agreement on the fly. So, returning to the car dealership analogy, this is where we have to fend for ourselves. I see a lot of older folks in the waiting room and I have to wonder…what sort of deal are they being given?

The American insurance system seems odd, but what I read from American audiologists online suggests that they really get jerked around by the insurance companies. It sounds like it can be difficult to figure out what is actually covered, and that there is consistent difficulty with the insurance companies actually paying what they initially said they would. From the stories I’ve heard, I’m suprised any of them even go through insurance given how often it seems that they come out on the other end losing money. Although it also sounds like there are restrictions that require them to go through insurance. Most of the time up here, the patient pays up front and then submits to their insurance for reimbursement. Much more straight-forward from our end.

As for how to find a good professional–same as finding any other good professional. Trial and error, trusted word of mouth, educational and professional history.

I’m sure there is a lot of truth to what you say. I wonder how much bundled pricing has to do with what they can bill the insurance for? I understand audiologists prefer to do bundled pricing upfront. This insures the customer will come back to get hearing aids properly adjusted. But I’m not naive enough to realize this also ensures they get paid for the next 3 years for appointments, that often customers never even attend. I guessing the insurance co. have started to clue into this.

@chrluc, I am no means an insurance professional, but here’s what the disparity btw your audi and insurance company might mean: while your insurance covers 90% of ___________ with no cap, the audi’s contract with your insurance company may specify that the max they will receive is $5000. Example: the quoted cost of your new HAs is $7000. You sign a contract for that amount. All you know is that if your insurance company accepts the full cost, your deductible is 10% or $700 max (premised upon a $7000 payment). But let’s say that your audi DOES have a $5000 limit by contract. Then the audi knows that they will receive $5000 and therefore the max you will owe them is still your 10%, or $500. What you need to be sure of is whether an in-network provider (if they are that) is limited by contract to the terms you have with your insurance company.

I could be totally wrong here, so maybe someone will jump in to correct me. I see this all the time in my insurance statements with doctors that provide a service and I don’t know what I will be charged. But I do see their billing statements and many times what they charge is not what they get paid. The insurance company adjusts the fee according to their contract on “usual and customary fees” with the medical provider. And I pay my percentage according to the final figure, not some arbitrary fee that the doctor chooses to charge. I hope that makes sense. FWIW, I would call my insurance company and check again what my coverage is, and what info I can obtain about this particular provider. Good luck!

Also, my meeting with my audi regarding the addendum I wrote went fine (I think). She looked it over and was ready to sign it. For some reason, she was overbooked and so with another client in the wings, she asked me to return next week to sign their contract (and both of us to sign the addendum). I’m fine with that. I’m equally surprised and pleased that it wasn’t a bigger deal. I appreciate that this clinic is laid-back and client-friendly and they seem to understand my reticence about their being out of network for insurance. Ordinarily I would never go to an out of network provider for the very reasons I wrote this addendum. Anyway, we’ll see how it goes next week.