BlackyZürich, CH 2021-now // Berlin, DE 2017-2021 // HR origin
I wasn’t speaking of , but proper fit using , aurical is the name of company that makes the device. I don’t know the name of headphones, I know that sw you have to pay, also one.
And good first fit with that takes 2 visits. Actually 1 but you do two just to double check.
Again, first fit. Where you have speech comprehension in quiet at or close to your WRS test with headphones. That test sets expectations what can do for you.
How can anyone know if they’ve reached that if they don’t measure it in the first place?
With bad fitters you can waste months and not reach that. Ask me how I know
Why? That you should ask them. I don’t see any sense in such approach, it’s frustrating, it’s long, and it might never reach possible maximum (again, ask me how I know )
After first fit you take notes and share findings and it’s further adjusted. Like ‘quiet is too loud’, ‘streaming is horrible, I understand only this word’, ‘I want to hear phone without streaming’, ‘I need a program for my concerts’.
But that’s not first fit anymore. I agree it is needed for your everyday use, however good first fit gives solid base to work further. Poor fitters don’t provide solid base likely never. They play guessing game, while equipment costs what, 10-20k eur. I didn’t check exact prices, since companies don’t put them online, but I think I saw aurical for less than 10k. Other stuff shouldn’t cost more than aurical. And you don’t need much - those headphones plus bone conductor with further sw and hw to do , then sw for WRS and SNR and aurical for REM. Probably speakers amd cables and maybe some mixer as well.
Gimme plain office but buy that equipment, and not waste money on a shiny office and do things in a bad way.
I don’t necessarily disagree with what you are saying, but in the interest of transparity maybe we can break this down a bit. Audiologists are professionals and you can expect their hourly fee to be on par with physiotherapists, optometrists, dentists, etc. We probably have more expensive equipment than physiotherapy, but less than dentistry. I’ve heard $200 USD used for the average hourly, with wide variations depending on location. (Internet says that’s 175 eur, but I know that just running a direct exchange doesn’t capture other cultural differences in pricing.) [You make an odd comment about $200 per day being a high salary, but $200/hour as cost-of-operation does NOT translate to a salary of $1600/day for the practitioner. My quick-as-quick google suggests the average salary for an audiologist is 64,000 eur. Compare to 106,000 eur for a dentist and maybe we can have a different discussion about the income disparity between male and female dominated fields–although I looked up american averages and ran an exchange, which might be a bad method because American audiology education may differ from German educational requirements and it doesn’t look like dentists make as much over there.]
For a set of new hearing aids with a 3 year service package, I would expect to book a minimum of six hours in-person with a new patient during that time. That’s assuming everything went perfectly smoothly with no extra follow-ups or office visits, and it is not counting time involved with administration.
The bundled model is tricky though. When services are bundled, they have to aim at some sort of average clinical time, which means they have to account for users who want to demo three types of hearing aids, users who struggle with adaptation to amplification, users who are picky about sound, users who cannot manage to clean their own devices, and users whose hearing aids break frequently. Tack on an extra few hours over the three years and we’re pretty much where you started. Also add something in for all those “free” hearing tests and consultations with people who do not buy hearing aids.
And then with bundled services we also probably need to argue about preferred practice. When you send a hearing aid for repair, do you expect the front desk staff to send it to the manufacturer and then hand if back to you? Or do you expect the audiologist to look at the hearing aids when they are back, ensure correct programming, and verify their function in the testbox? One of these services is certainly more expensive than the other, but hearing aids do not consistently return from the manufacturer set correctly–sometimes they come back completely non-functional. Also, what is the preferred number of annual appointments? My estimated hours accounted for one hour-long annual appointment to re-assess hearing and verify the function of the hearing aids. Arguably, it’s not that common to see much variation in hearing annually–maybe every two years would be better unless the patient is reporting perceived changes. But 16% of directional mics fail within the first 6 months (IIRC), so maybe every six months would be better for verification.
There are other options and complications involved, but yadda yadda yadda. I just wanted to be clear that the price of the hearing aid relative to the base manufacture price is not just an arbitrary “mark-up”. In bundled models, much of it is the cost of associated professional services and it is directed at an ‘average’ patient which means it will advantage those who take up a lot of clinical time and disadvantage those who take up less (e.g. experienced, easy-going users who take good care of their devices). I agree with you that unbundled services would be better. However, in many cases consumers prefer the optics of the bundled model. They feel like they are getting a better deal because the batteries are “free”. Further, unbundled patients may be less likely to come in for appointments that they really should be getting.
Per the system: I would agree with you that if the professional is just selling you a box with a Roger Select in it across the desk any associated mark-up should be minimal. If they are verifying its function, teaching you to use it, and following up to make programming adjustments to optimize your experience with it, that is going to cost more. HOW MUCH more it should cost is a reasonable question.
I am not saying that I think hearing aid pricing is 100% reasonable. And I definitely agree that there are shady, predatory practitioners out there.
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BlackyZürich, CH 2021-now // Berlin, DE 2017-2021 // HR origin
I know that hourly rate doesn’t transfer to salary, but it’s good to illustrate situation here.
150 eur /session is what my fitter asks for setuping devices not bought with him. So I didn’t pull out the number out of the thin air.
And it does not make sense to me that cleaning and fitting cost the same. Granted I didn’t ask for maintenance prices. But since I perceive him as fair guy, I’d expect lower.
But, when people buy, it’s mostly 2 , so that’d mean min 20h of bundled fitting service. And you just don’t need that for REM.
My point - I got a discount and he is still earning enough money out of it, because he doesn’t need those 20h of fitting because he does REM.
Those who don’t use REM can easily come to those numbers, and it would look like they’ve offered you more, when in reality you’re just paying for their incompetence. Plus, they don’t have equipment, obviously
You just don’t need 20h of fitting if someone is doing their job properly.
You need 2 of those in average case (also information from my fitter). Then depending on your lifestyle you need other tweaks and maintenance, but I think we can agree that fair fitter wouldn’t charge you the same for ‘can you please make everything louder’ vs 40-60 min long session of REM fitting from scratch.
Also, here isn’t uncommon to see 15 min prices. Like consulting with your vet, and other private medical consultants. Since you get 15 min and not a full hour
I was accounting for a single initial fitting session and one follow-up in my initial calculations. I agree with you that we are well past the time that all practitioners should be regularly using REM. At least in North America. I understand there are countries where it is more more difficult to get.
But you’re correct, two hearing aids doesn’t really double the work. It’s not the same as one, but it’s not quite doubled. It seems a bit odd that there isn’t a 2 hearing aid discount in most places.
Pricing a assisted hearing device (not aid) near $1000 a pop is rather “Over the Top”, but what’s also interesting is that the Roger Pen is really irrelavant as long as the coronavirus is around due to maintaining a six foot distance from others. With masks hindering clear conversation and then the distance factor, the Roger Pen is not going to work as advertised.
Also every time Phonak shows a picture of the Roger select at a table setting - the table is pretty much bare bones. Like nothing on table, or maybe just a glass of water. Its quite obvious that Phonak through picture illustration is telling users not to put anything near the Select that might block its signal. I’m all for fairly priced hearing aid accessories that do what they are supposed to do. But with Roger devices I really don’t think you get what you pay for.
I put select on the top of ashtray turned over and remove bottles/glasses directly around it, give it a bit of space. But it’s not that I check for each trajectory between mic and people’s mounts. It’s a beast of a mic, it catches everything you want and reduce noise.
Most fun for pen and select was to put it below my cat’s nose and hear them breathing in my ear
With pen in noise I’m not happy, either I don’t aim well or it just catches everything non filtered, and when I walk it bears all that wind from my hands moving. Or maybe mic on this used one isn’t good… But then, I shouldn’t hear the wind either…
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Dani"Make Germany great again" "Germany first!" Ⓒ1933-1945
You’re missing a very important point: in Germany there are LOTs of people who try three or four , test each of them a couple of weeks and give them back without paying anything. The dispenser has a lot of work and direct costs but no income at all at this time. These 150€ per hour is a big joke for them. Indeed 90% of sold HAs in Germany “cost” 10€ for the patient/customer the remaining 700€ is paid by NHA. From this money the dispenser also has to pay all repairs for the following 6 years for those 90% customers. Except for custom ear molds and batteries.
Edit: don’t know why my reply went to Neville. Blacky was ment.
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BlackyZürich, CH 2021-now // Berlin, DE 2017-2021 // HR origin
Edit: don’t know why my reply went to Neville. Blacky was ment.
Because you clicked reply on Neville’s post and quoted me (but not clicked reply on general topic or my post)
With proper fitting each setup is what, 1 visit?
And of course they return, since prices are so high and process endless and useless since they don’t do REM based fitting.
I returned first marvels mainly because of price and incompetence to fit them to hear better with them than without them.
So, that return really isn’t my problem.
But basically what’s the end result, we pay high prices because of their incompetence to fit us and then we have to pay to compensate because many people withdraw, again because of their incompetence and/or high prices.
Makes no sense to me.
Should I mention that the first guy never told me that there are basically free devices for us customers and that they give same results in quiet? Not to mention that he never said that there’s possibility to ask insurance for full coverage? Because then he’d have to wait for the money.
And that first guy had the best reviews in my area, people complaining that others want to just rip you off. Because first guy definitely wants to rip you off, but it seems that others do it less subtle.
So, can’t imagine how bad those others even are.
Not to mention that I was told by one association that almost none will work with aid that isn’t bought with them. Like lady whose job is to advise people about their rights and possibilities didn’t know about anyone in Berlin until I shared my guy.
I find that outrageous. Like a mafia, you can’t get out once you’re in, since other person won’t accept you bc you didn’t buy with them.
And also I feel like I found best dealer in the town whenever I say ‘my guy’ but it seems that finding good fitter even rarer
Also, only repair they can do is changing the receiver / tube, plus cleaning, everything else goes to manufacturer anyway, so basically cost is postage. And cleaning rate should not cost the same as full attention fitting rate. You don’t need dr aud degree to clean .
Plus repairs are only around 125 eur from that sum of 700, if you need more, you’ll pay, not your insurance anymore. If I understood that part correctly. I was more focused on finding out how much it costs if I destroy it and bring parts (around up to 200). Because also not all damages are covered, eg for gross negligence you have to have additional insurance which then at the end cost roughly 1/3 of the price and goes at most 4 years. While insurance gives their contribution only every 5 years. So last year you’re on your own anyway, and first year or two are covered by manufacturer anyway in case of something is really wrong with the aid. Plus that additional insurance I’m not sure it covers normal wear and tear, I think not.
And I think we can agree that repairs you might need exactly are from normal wear and tear when device is older.
In my eyes bad fitters are only working on blowing up the illusion how they work hard for you and making themselves indispensable.
Also, I’m not sure about your 90% estimate for ‘free devices’, my guy did say they’re majority, but also that people don’t buy max tier (eg marvel 90 but 70 or even 50), but we didn’t specify the numbers.
Judging by what people would bring for quick checkup/update/cleaning when I had an appointment, they definitely weren’t those free models he showed me that he has, but mostly cic and similar miniature ones. Afaik, free ones are bte, tube or ric ones. But of course I might be wrong, I conclude from what he offered me to compare with marvels.
One thing he also said is that he really doesn’t care how many aids someone compare or how long trial takes or which manufacturer you’ll end up buying.
Since he fits them in 30 min. And customers obviously see the benefits of his service since he’s fully booked up to 2 weeks in advance
I have to ask him if he has people who try and then not buy anything. I seriously doubt that, based on his reviews and my experience and all those customers that drop in with some issue and how fast he helps them. But would be interesting to hear the numbers.
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Dani"Make Germany great again" "Germany first!" Ⓒ1933-1945
And of course they return, since prices are so high and process endless and useless since they don’t do REM based fitting.
They do based fitting.
Most customers in Germany are told by their friends and Family that they need and that those are without any costs. They should try listening with HAs but they actually don’t want to. That’s the reason why HAs are actually not bought. Most people think that they still can hear without them very well although this is wrong.
You know Thomas Gottschalk the German Entertainer living in California? He definitely needs HAs but he refuses to buy some although he gets a huge salary for advertising them.
You’ve said that your first fitter didn’t tell you a single word about “free” HAs. He has to fit you with at least one free HA. Otherwise your insurance won’t pay anything in Germany. You have to sign a document that you have tested one. But this is a local country issue so it’s better tio ask a local forum. On the other hand meanwhile you found out most important things by yourself and no longer need further help.
I’ve had pretty good performance from my Select iN when I just plop it on a table, whether or not there are intervening things. In one case I remember, we were at a Chinese restaurant with one of those lazy susan thingies in the middle of the table. Even so, with the Select iN in front of me, I could easily hear my brother-in-law half way around the table. So much better than no extra help at all for my .
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BlackyZürich, CH 2021-now // Berlin, DE 2017-2021 // HR origin
I searched for some in Berlin. Found 3 sites that mention it. One is my fitter, another is another one and third is some agency that connects you to fitters but you don’t know with whom. My fitter is in that network and he confirmed me that even though it says on that page, fitters aren’t obliged to do it to be in that network.
And when I asked him who else does it, he said that another one which I’ve found and fielmann. And that he doesn’t know about any other.
I had better opinion about fielmann until last week, after 2 measures and 2 glasses and adjustments they couldn’t get it right and caused me eye mucle ache, never felt that before in my life. Maybe with they’re better. Went to local solo practice, got new measurements and I need 0.75 less?!?! Crazy how those two in fielmann didn’t manage to find that out. I mean, that’s big difference.
So yeah, I’m a bit vary of their competence now but they’re big network so it depends on where you go.
Maybe it’s better in your area?
I decided that if I ever move out of Berlin and couldn’t find fitter, I’ll visit this one
They should try listening with HAs but they actually don’t want to. That’s the reason why HAs are actually not bought.
Ok, true that, forgot those. But, you really think they’d go for trials of several brands and many meetings/fittings and still not buy it? Ok, weird.
I got the impression that such people would buy it and leave it in a drawer.
Actually I’ve seen some stats from phonak about how big percentage of their aids through the platform generations end up in drawers. Like, big number. But they say it’s getting lower with newer platforms.
I think all could be resolved by unbundled service, like some opticians do - eg 25 eur eye test, or free if you buy glasses there. With HAs 50 eur one setup and 2 week trial per aid, or something like that, that’d be deducted from the bill if you buy.
And then we pay per fitting, or checkup, cleaning up and stuff.
I’m totally up for paying for the service. I just hate when they force us to pay for the incompetence or their losses.
I think it would be interesting to see the prices then.
You’ve said that your first fitter didn’t tell you a single word about “free” HAs. He has to fit you with at least one free HA. Otherwise your insurance won’t pay anything in Germany.
Yup, he must have ‘forgotten’
Maybe he’d give me a document to sign but he definitely didn’t mention any ability to get them for free. On their site I can’t remember seeing ‘free’ ones either.
Ok, I do have active lifestyle, but, he didn’t know my budget so I think it would be fair to offer that maybe. Don’t know. He immediately offered me select as well seller
Was just thinking of another way to look at this. If one is trying to optimize speech in noise for the least cost, it might be a much better idea to spend the money on a Roger Select and combine it with a less expensive hearing aid (M30 or P30) Alternatively one can get creative and come up with non Phonak solutions to use the Roger Select. I think it can be argued that a Roger Select offers much better “value” than upgrading to a M90 or P90.
This is what I have done. Researched into the pros and cons of getting the M90’s. I settled on the M30’s due to the lower initial outlay. And add a Roger Select later, I’ll still come out in front. Waiting to get into my Audi now for my Roger Select trial. Cant wait to give it a try.
Once I’ve had my trial, I can submit my rebate request to the Govt and they’ll reimburse me for the cost, which has made @Blacky jealous
might be a much better idea to spend the money on a Roger Select and combine it with a less expensive hearing aid (M30 or P30)
Depends on what is your daily usage, but yes, it’s awesome solution.
If you are only at home in quiet, shop among familiar faces, and on events where you sit (restaurants, bridge club, knitting club and similar) m30/p30 + select IMO better solution than m90/p90 alone. And definitely cheaper.
Nothing can beat sound source few mm from your eardrum.
But people oftentimes don’t stop and think about their use cases.
Route of getting select to work with other manufacturers is more expensive and oftentimes subpar, eg if it uses tcoil. I’ve checked that and for ric devices there’s not much to do, regular big can use DAI shoe for their aids and that brings the quality up.
I’d argue that it might even get sense to get cheapest marvels plus select for select situations, and then other you like for other situations, depending on prices you might end in the same ballpark but with better quality with mics. Compared to forcing non phonak to work nicely with roger
I was just wanting to make the point that Roger Select can be used with other hearing aids. Personally I agree that use with Marvel, Paradise (when bugs are worked out) and other compatible aids (KS9, and some from Unitron and Hansaton I think) makes more sense.
So best is having receiver inside the aid (marvel & co).
Second best is DAI shoe and X receiver. That works in theory with other manufacturers (you need their DAI shoe), but, not all models have DAI shoes (from my short research, only big with tubes have it, but do not).
After that, you’re dependent on tcoil or plugging X in the device from that manufacturer, but then you get latency issues. And quality drops since it gets compressed along the way.
So basically if you buy flagship RIC from someone else but you won’t be able to get the best sound quality out of roger select.
Price of select for my fitter is around 650 eur. Or 680, I forgot the middle number.
"Make Germany great again" "Germany first!" Ⓒ1933-1945
Reading, Massachusetts, USA
Australia
glad it is going to work out for you 
Wales, UK