I was wondering if anyone has had any recent or semi-recent experience submitting an insurance reimbursement claim for hearing aids purchased from Costco. My insurance (Blue Cross Federal Employee) will reimburse up to $2500 every 3 years for hearing aids. The only thing is the requirements for submitting a claim form seem to require a procedure code on the receipt as well as a diagnosis code. A previous audiologist (I had trialed and returned a pair of Oticons in November) already submitted and received partial reimbursement for a hearing test done there so I think that will probably satisfy the diagnosis code requirement (plus the Costco hearing test was free anyway… no insurance reimbursement required). The problem with my HIS at Costco with whom I am getting the KS9’s from is that he isn’t providing a procedure code. I’m going to ask if he can include a code on the receipt when I pick up the hearing aids but I’m not sure he will be able or willing to do that. I’m tempted to write in the code myself (if I can determine the proper code) since it’s all legitimate. Any suggestions or prior experience with this would be greatly appreciated.
Thanks in advance.
From memory I remember members talking about the receipt you get from Costco when you buy hearing aids having all the needed information on it to fill out an insurance form.
Maybe someone will jump in on this thread to help.
I have a small, regional Medicare Advantage plan, Golden State Medicare Health Plan (www.gsmhp.com) that pays $400.00 every 3 years for hearing aids. I just submitted the Costco receipt, complete with audiogram and all info. It did not have the medical codes listed.
Those codes are on the Medicare website (very hard to find), also they are in the pdf documents that my plan has online (I download and keep them on my computer). On a few occasions when I needed those codes to submit, I actually called the customer service help line for my insurance plan and they looked them up for me while I was on the phone with them.
Costco would not bill insurance directly, I had to submit the invoice and a brief letter explaining the sction of insurance benefits that I was seeking reimbursement. All went smooth, and it took about three weeks to get a check back from my insurance.
I also bought HAs from COSTCO and was reimbursed by my BCBS Federal Employee Program. The code my ENT provided me was diagnostic code 389.10 when I purchased my HAs two years ago. COSTCO did not or would not provide that code. They told me it had to come from my ENT, so I simply called his office and got it. I would have thought COSTCO already knew that code.
One more thing. I did not have to provide a procedure code according to BCBS when I talked to them.
Thank you everyone for your replies. So does anyone know the procedure code for the KS9’s if I do end up needing to provide that? I assume it’s a universal code for BTE pair of hearing aids?
The procedure codes are for the testing procedures, NOT the hearing aids themselves. These test show one needs hearing aids and the Audiologist / HIS is providing them for a reason, not just to sell a product.
These are the tests done at Costco and I received procedure codes for all. Unfortunately I did not keep a copy of that, sorry.
1-standard pure tone thresholds in each ear.
2-bone conduction on both sides (I only had 1 at the 3 others, only on one side).
3-word recognition "say the word (two syllable) in each ear.
4-word test with one syllable getting quieter until I could not understand in each ear.
5-most comfortable loudness of tones in each ear.
6-loudness comfort with voice (someone reading until it was too loud) in each ear.
7-someone reading & I could ask for louder / softer until I found the preferred volume level in each ear and then both at once.
I had the exact same issue with my last pair from Costco when the FEPBlue reimbursement was $3,000. They demanded a procedure code despite the fact it was clearly visible on the receipt and diagnosis page. I wrote an exceptionally strong letter noting that fact, backed up with a separate statement of the code from the Costco audiologist, and told FEBBlue that they were 90 days in arrears and I was going to start charging interest at 18 percent per annum. Not that that threat made any difference, but I did promptly get a check and a letter apologizing for the delay.
BCBS FEP program states $2500 every three years. How did you get $3000? I hope your right.
That was in 2016. The number went down to $2500 in 2019. I got new aids last year but used a buying service that took care of filing for the rebate for me. No problem with that transaction with FEP Blue. Got a check quickly.