Buying aids from an independent audiologist clinic vs an ENT office?

Hearing Aids
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what has been your experience? USA, health insurance does not cover anything

I bought mine from an independent Audiologist…a one-person show. This is my first ever set of aids so that is the total of my experience.

I didn’t fully understand this at the time but it was a bundled deal. Price was as I now understand it roughly double the real price of the aids, but included unlimited visits for a time and loss or damage insurance, also a loaner set the one time we had to send them off for repair. Audi has been great to work with but is old school, has no back-up when out of the office, and can be a little hard to get in touch with

I understand that it can be cheaper to buy through an Audi working through an ENT’s clinic. I’m guessing it’s more like a pay as you go model…

As much as I feel like my audi’s experience has been valuable in setting up and maintaining my aids, I’m just not so sure the x2 markup is worth the insurance and such…but maybe it is?

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I’m doubtful it would be much, if any cheaper through an ENT clinic. If you liked your Audi, you got good service AND your aids actually help you quite a bit, I’d say it was worth it. Less expensive approaches are Costco, buy via online providers or buy used and learn do it yourself programming.

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I use an independent audiology office and they, too, wanted to sell me aids at what would have been roughly the price at an ENT office. I do business with an on-line retailer who has a relationship with the Indy office I use. The audiologist was new and not aware I used the outside firm. They promptly said by all means, buy from the online outfit, have them sent here and we’ll get them programmed. This practice works with the online firm, but would be very happy to sell them at the ENT price if they could. I just made sure they knew I knew I could do better elsewhere.

You may get a bit longer bit of post purchase service with the ENT office, but I have found that the post-purchase follow up for warranty and reprogramming/adjusting to be just fine. I ultimately will have to pay for some services down the line but I still come out way, way, way ahead financially dealing with the online retailer and an affiliated audiologist.

Oh, yeah. I paid the online retail their full price, about $2500 less than an ENT or my audiologist practice, and they then promptly filed for the insurance rebate for me. I actually had the insurance reimbursement check in hand before the new aids arrived at the audiology shop largely because I was catching the cusp of a new Oticon offering and it took some time between when I placed the order and when the new units were formally released! If you go the online route, the outfit I used and am very happy with is Ziphearing.com … there are other firms which operate the same way as well and I’m sure you’ll find folks here who have dealt with those as well.

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reading between the lines it seems like you might have experience that an ENT office charged more?

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Brad: Just a brief update after a memory bubble erupted. I’ve been using aids since 1998. I remembered this morning that at least the first two sets I got were from an audiology shop attached to an ENT practice, one my dad used. At least for the first set, I had to finance them over a period of time. I cannot recall but maybe by the time I got the second ones BCBS was providing $3k every 3 years —- something that has been substantially altered as they tumbled to the fact how deaf my generation would become! Subsequent to that, I got the Bernaphon knockoff of Oticon at Costco at a price within what BCBS would pay, though I had to do the legwork on getting reimbursed.

The audiologist I now use at the independent practice was formerly in an ENT office and told me what the independent practice charges for aids tracks what the ENTs charged … roughly $7k for top of the line instruments. I also saw a price sheet sitting around when I visited an ENT recently on a non-hearing issue (whew) and those were in the same ballpark. Further, I see the same sort of pricing being cited by folks here who reference ENT practices. I’m very pleased my audiologist still does business with the online operation.

The beauty of the online outfit I use is not only is the price substantially below what ENT/Audiology shops charge, they will file the insurance paperwork for you.

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I’ve gone 4 routes:

  1. 3 years seeing an audi at a clinic that sold aids at market price, but charged me about $120 per visit thereafter. HORRIBLE experience, and felt there was no value at all. The audi pointedly told me, “My goal is to fit you today and never see you here again.”
  2. 2 years with audi at small clinic with no other staff available who only sold Starkey aids. His labcoat was a Starkey billboard, and indeed, that is what he sold me at market price. Follow-on visits were free, but I resented the one-shop option.
  3. 15 years with a one-man audi who owned his own clinic. FANTASTIC experience, and aids were sold at market price; follow-on visits were FREE.
  4. Now 3 years (and counting) at ENT clinic with staff of audis, altho I only work with one (my preference) who’s trained by Phonak. Aids sold at market price (maybe a few hundred less than the owner-audi), and follow-on visits FREE.

Not sure what you’re paying for what make/model of hearing aid, but as far as I know, one of the lowest cost options is via Costco for a brand of aid they carry. Dispenser may not be as knowledgeable or patient as a dedicated audiologist tho…

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I will add here that there is often one, kind of similar, but different place to go.

After getting crap hearing out of expensive aids from local stores, audi office tied in sellers, etc I went searching for an alternative.

To my benefit(?) I knew I was probably due for at least one Cochlear implant.

I managed to get accepted to the ENT clinic at Mayo Clinic in Rochester MN, which is the flagship place for Mayo. Long wait and a million hoops to go through, but worth all it 10X over.

I got a 4 hour comprehensive hearing evaluation from an Audi that does almost only those testings and was extremely good at it and thorough. Results were one ear just qualified for Cochlear and one almost did. For a final test she programmed per her data a pair of mid grade OTE aids with just foam earpiece fits. Then I was tested or word recognition and did noticeably better. She said I MAY want to consider trying some good hearing aids on a trial period to see if they would be worth buying. I next went to the ENT the same day and he agreed with the Audi about one Cochlear and said he was fine with hearing aid trial as it might be enough to buy time until both ears could go Cochlear and could get the hearing therapy at the same time, a big benefit.

Mayo does have an audiology clinic that fits hearing aids, and will do any brand and model you want. Full retail like any audi would charge, 3 year warranty, free parts like domes or wax gaurds, free followup visits, so a much better setup than I had ever run across.

Fitting Audi was a PHD in Audiology and very experienced in fitting. Did all the right fitting things like real ear readings and such. I wound up with Resound Nexia 9 size 13 battery aids with earmolds as they would also work with Cochlear if I only got on Cochlear. The results were hugely different and far better than anything I had gotten anywhere else. Since it was an all day drive for appointments for me, and I had over 15 years of self programming on other aids, I asked if she was OK with me tweaking so I could do real time testing at home at at the noisy places I often go to and she thought that was fine. I keep her informed what I am doing and the changes made and she learns along with me what works the best for me. I have done around 50 different combinations of features and programs and tested them. What I have found does best is not what either of us thought would be best, but now I hear very well compared to even the original fitting, don’t use the mini mic at all anymore in our noisy RV or noisy places, and only the TV gives me some difficulty now sometimes. I hope to get several years of good use before it is time for Cochlear on both sides.

Bottom line is if you can find a major research hospital/clinic you are likely to have access to the best of the best Audis and ENTs. At Mayo, they all have lots of research papers published and continuously are doing cutting edge research. Almost feel like I won the lottery sometimes.

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Honestly, 4 hours of testing? I’m glad you had the time for it.

I appreciate that this might seem trite, but even with full REM and soundfield evaluation we’d be struggling to make 1 hour 30m.

Perhaps there’s some lengthy stuff they do that needs a lot of set-up, but I think that’s a heck of a long fitting.

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Yep, it is a 4 hour appointment, but of course not all of it is in the listening room, there is some discussion and recap time in their. The actual fitting was at a later appointment so not included in the evaluation appointment but the fitting one did not need to do any real testing except after programming and installing and a resonance/response test.

I can tell you that keeping concentration on listening for the long periods of time was difficult and exhausting, which they know and tell you it is going to be hard up front. There are breaks, also, a couple of times. I don’t know how many tests or what they would called, but they did seem to go on forever. Lots of different voices from male to child, different sentences and words for all of them, different speaker placements for full 360 degrees and angles, with and with many different kinds of noise overlaid.

I think, to me, the proof of if it was worth it was at the fitting when they were programmed and put in. The only test done then was for resonance primarily and two ranges were adjusted for that. I heard surprisingly well right out of the door with them and that had never happened in the past with any audi or fitting specialist.

After all my home tweaking and testing, my gain curves are still very similar to the original programming and initial tweaks with mainly compression changes to balance loud and soft. I actually wish I could get more than 3.0 compression the programming allows for certain frequency ranges. Different microphone settings, especially the auto directionality ones, do make for some gain curve necessities, though.

Where I was able to make the biggest gains in hearing quality was mostly related to the multitude of “automatic” features available. Lots of directionality, noise canceling, ear to ear transfer, spacial effects, etc so very many combinations available. What I found was that there was a lot of conflict between them and also that they could pretty easily get fooled by quickly varying, or unusual situations, especially if more than one them was on. The most stunning of them showed up while riding my bicycle of all places. They were set for “front focus”, moderate noise reduction, and with ear to ear communications on. The aids sit just below the helmet edge and the wind does make noise there, it always has with any aids in, but with these settings it took the wind noise which is a lower frequency noise as voice it appears, focused on it and amplified it, and then doubled the volume again by ear to ear communication. It was like freight train sound. If I turned off one aid, the noise went to about 1/4 the volume.

I currently am running very well, best ever, with fixed directionality that is said to super or hyper cardoid, low noise reduction, ear to ear communication off. Gains, particular on the low input/high gain curve have been tweaked slightly to match the noise frequencies that seem to interfere with speech for me the most. Cochlear is in the future, but this is certainly usable in the real world pretty well.

On Friday, October 18, 2024 at 02:16:45 AM CDT, Stephen Bright via Hearing Aid Forum - Active Hearing Loss Community no-reply@forum.hearingtracker.com wrote:

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I can imagine a long fitting possibly being productive and not a struggle if being thorough and organized.

I just got some custom molded slimtips yesterday and so my programming is all off. Agrevated I think by my aids seeming to be on the fritz…

Anyway I’m reminded of the first month or two of getting these my first ever hearing aids. (because I feel like I might have to go through this routine again)
There were a lot of little quick trips into the audiologist for follow-up adjustments. I’d find little things that didn’t sound right…

  • a certain situation sounded too “hot”
  • too much hair noise
  • etc…
    each time she’d say come on in…we’d talk, she would tweak a setting, it would be better…
    lather rinse repeat. Sometimes the visits were maybe only 5 minutes…

She was great applying her experience and knowledge to foresee some of this and home in on a great fitting fairly quickly
And in hindsight I’d say that some of that was the process of training my brain for the new normal
But I can imagine a very thorough and well-planned fitting where many of these common situations could be addressed in fewer long visits than a whole bunch of little short ones

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If you are happy with and your audi good at doing the right tweaks for you, the current state of the art may be able to help you in that remote programming changes are now very common. I have the availability of them but have not needed it now that I have the programming stuff. A couple of minutes on your phone and it can be done when you are anywhere you have good data coverage.

The long fitting was very methodical and organized, so not long setup times or confusion at all, but if you take it a seriously as is needed, the concentration level has the be pretty intense or the results will be inaccurate. The audi said some people needed lots of breaks during the time or their minds wandered.

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It was a CI eval though.

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Ahhh. Sorry, missed that.

Fair enough for a full clinical assessment.

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