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Telecoils

Telecoils are an old technology from the late 1930s and most hearing aids have them. They were originally designed to help hearing impaired people hear clearly on the phone. Today, they are used more often in theaters with an induction loop. A room is “looped” with a wire that receives the sound signal from the stage and then transmits it to the hearing aid. This turns hearing aids into something like a custom headset. A California hearing aid impaired group recently tried to pass legislation requiring audiologists to include a telecoil in every hearing aid. I encourage everyone to choose one with a telecoil, but, for some people, they’d rather forgo the feature in favor of either a smaller hearing aid or another feature like rechargeable batteries. If you have hearing aids and aren’t sure if you have a telecoil, you’re welcome to come by and I’ll check. If it’s in the aid, but not activated, it’s pretty easy to do so. I have included a video explanation of how a looped room works with a telecoil in the Hearing In Noise section of this website. Ampertronic has a history of the induction loop on it’s website.

Hearing Aid Insurance Benefits

Always call the number on the back of your insurance card to see of you have hearing aid insurance benefits.  Ask if there is a special rate for in network providers.  If there’s no difference between in and out of network, then you can go to any hearing aid provider.  Also, ask about deductibles and how often they provide that hearing aid benefit.  Regardless of my status with an insurance company, I’m happy to submit claims electronically and that speeds up the process of considerably.  I’m in the process of applying to insurance companies.  Here is my current status.

 

In-Network

  • Blue Shield
  • MediCal/CenCal
  • The Department of Rehabilitation

 

Waiting to be In-Network

  • EPIC (Applied this month)
  • Aetna (Applied 2 months ago)
  • Cigna (Applied 3 months ago)
  • Anthem Blue Cross (Applied 8 months ago)

Medicare

Medicare does not cover hearing aids, but a lot of secondary insurances require the claim to go to Medicare first.  Once it gets rejected, Medicare forwards it to the secondary insurance.  Everyone who works with hearing aids knows that Medicare only covers an annual hearing test, not hearing aids.  For some reason we have to do the extra paperwork.

 

Credentialing

Because of a process called “credentialing”, becoming a provider takes a long time.  Credentialing is the process of establishing the qualifications of a licensed medical professional and assessing their background and legitimacy.  It takes months to become an in-network provider.  In the case of Anthem Blue Cross, it has taken 8 months so far.  We just signed a contract with them and now we’re waiting for them to sign it.  So far, I’ve been “credentialed” by Sansum Clinic, Blue Shield, Anthem Blue Cross, MediCal, Medicare, and the Department of Rehabilitation.  Maybe some day there will be a standard process where they just accept a diploma from a reputable university and call your last few employers.

 

Claims

It takes a lot of work to submit and process claims.  I usually spend a good portion of my Fridays working on insurance claims and it grows every year.  I anticipate there will be times when I will have to wait a month before I can see a new patient with insurance so that I have time to process the claim in a reasonable amount of time.  Maybe some day anyone with a hearing loss will have access to at least a good basic hearing aid, without lots of paperwork, regardless of income.

If This, Then That (IFTTT)

“If This, Then That”, or IFTTT is a cloud service that uses connections, called applets, to link internet enabled devices (like a TV, door bell, lights, or fire alarm).  It can also link devices to online services (like your email account, Facebook, or Twitter).  So hearing aids can now do some pretty useful and fun things you may never have imagined.

 

  • Your hearing aids can tell you when you get an email or when the door bell rings.
  • A mom can get an alarm on her phone when her daughter’s hearing aid batteries go low.
  • Your coffee maker can start when you close the battery doors on you hearing aids each morning.
  • You can hear a live music concert through your hearing aids.

 

Watch this video to see what I mean.

The website for the cloud service is www.ifttt.com.

Customizing a Hearing Aid

 

(Probe Microphone Test)

 

Hearing aids are expensive, in part because customizing a hearing aid is labor intensive.  (I wrote a blog post earlier on affordable options.)  Unlike a non-medical, high tech device like a “smart” phone.  You buy a phone, thank the salesperson, and out you go.   It doesn’t take more than 10 minutes and the salesperson doesn’t need a college degree to know how to do it.  It’s also not like getting glasses.  They make the glasses based on your prescription and you’re out the door.  It doesn’t take more than an hour and, again, it doesn’t take a college degree to understand how to do it.  With hearing aids, the initial fitting and follow up visits for fine tuning throughout the life of the hearing aid take hours.  I also takes a graduate degree to do it well.

 

The standard of care for fitting hearing aids includes two tests: probe microphone test and a speech discrimination test.  I just learned from a hearing aid manufacturing rep that only about 10% of audiologists do the first one.  Without it, you have no idea how close the hearing aid is to the patient’s prescription.  A clinic in Minnesota made an excellent video explaining probe mic measurement.  Physical fit is also custom, but that’s for another blog post.

Hearing Aid Batteries

Tips to Prolong Rechargeable Battery Life

Rechargeable batteries last about 1 year and cost about $30 each.  How long a charge lasts depends on how much you stream phone calls and media and how severe your hearing loss is.

18-19.5 hours      No streaming

16-17 hours          90 minutes of streaming

15-16 hours         4 hours of TV and 1 hour of phone streaming

1. Charging

Always fully charge the batteries, until the light in the charging dock is solid

green – it takes approximately 7 hours.

2. Out of power

If the batteries are drained and the hearing aids have switched off, never try to

get more use by opening and closing the drawer. Either:

a. Place the hearing aids in the charging dock and ensure it is powered on.

b. Insert disposable batteries and keep the rechargeable batteries safe for

charging later.

3. Not in use

If you are not using your hearing aids for an extended period of time, take the

batteries out.

Note: Avoid leaving the rechargeable batteries in the hearing aids with the

battery drawers open. This will compromise battery life.

4. Handling

Don’t keep the rechargeable batteries together with metal objects such as keys

and coins.

5. Maintenance

Wipe off any moisture on the hearing aids or charging dock before charging

using a soft tissue. Do not use rubbing alcohol or other chemical substances.

Tips to Prolong Non-rechargeable (Zinc Air) Batteries

Zinc-air batteries will last from 4 days to 2 weeks, depending on the size of the battery.  Prices vary dramatically.  At the drug store, you’ll pay about a dollar per battery.  At Costco or Amazon, it’s about 25 cents.  We have batteries too.  They’re about 90 cents each because we can’t buy in bulk.  We will mail them to you though.

1. Wait 5 minutes after you take off the tab before you put the batteries in your hearing aids.

2. Open the battery doors at night.

Unilateral Hearing Loss

Adults with Unilateral Hearing Loss

People occasionally ask if they really need two hearing aids. The answer is, yes, you do. If you need to save money, it’s much better to get two less expensive hearing aids than one high tech hearing aid.

There two reasons why, but first I have to explain that if one ear is at least 30dB better than the other, you brain ignores the poorer (unaided) ear. Even if the sound is loud enough for the unaided hear to hear, the brain can’t use it. Having explained that, unilateral hearing loss presents two problems:

1) Inability to tell where sound is coming from, which is a safety issue.

2) Significant difficulty hearing in noise. (For anyone who has normal hearing, I strongly recommend you experience this by putting one earplug deeply in one ear and have dinner at a loud restaurant. You’ll see how much harder it is to hear in noise with only one normal ear.)

 

 

Unilateral Hearing Loss in Children

For kids, unilateral hearing loss is an even bigger deal than doctors and teachers often think.

1) Kids with a hearing loss on one side are 10 times more likely to fail a grade or need help keeping up in school.

2) Kids with hearing loss in one ear are 5 times more likely to have some problems getting along with others. As Hellen Keller said, “Blindness separates us from things, but deafness separates us from people.”

It’s also more important to act as soon as possible than doctors and teachers may assume. Children pick up most of their language between ages one and five. The time between ages one and five is called the critical period.

Schools will set up special individual support for kids with hearing loss. It’s referred to as an IEP or a “504”. Here are a few typical accommodations, but there are many more:

1) Preferential seating
2) Extra time for taking tests.
3) FM amplification systems
4) Classroom noise reduction
5) Buddy system for notes and in class explanation
6) Dictation apps

Reference:
Karen L. Anderson, PhDSupporting Success for Children with Hearing Loss

Quiet Restaurants in Santa Barbara

It’s hard to find quiet restaurants in Santa Barbara.  If you wear a hearing aid, this is pretty important.  I posted this a while back, but a patient of mine just recommended a new one for the list, Louie’s. Email me if you have another for me to add: audiologyhome@protonmail.com

 

Louie’s (table # 8)
Rudy’s
Paradise Café (Veranda)
La Playa Azul (Veranda)
Scarlet Begonia (Patio)
Lure (in the back of the restaurant at 5 pm)
Rose Café
Stella Mare’s
The Patio Cafe
Meun Fan thai cafe
Tree House
Max’s (after 1pm)
Clementine’s
D’Angelo Bread