TPA Limits
In today’s hearing aid market, almost one in five patients get their devices from a third-party administrator (TPA). Audiology professionals can’t ignore how managed care plans like these may affect business if they wish to remain profitable. Though they may initially present a lower price tag to customers, these plans only purchase the device and do not offer the substantial benefits of the continuum of care model in a traditional direct-pay treatment plan.
Along with big-box channels and other managed care options, third-party administrators represent approximately 40% of all hearing devices on the market.
- These plans also present several difficulties to practices.
- Because the audiologist is only paid the fitting fee in these instances, reimbursement is lower.
- Additional TPA-related paperwork and processing can overprioritize employees’ time. TPA patients should be carefully integrated into your practice’s schedule so that timeslots for self-pay patients are also still available
Developing a solid strategy to manage TPA patients effectively while still providing them with the option of the medical model of care is key to keeping your patients’ hearing and your practice’s finances healthy.
How Fuel Helps: We’ll partner with you to help you navigate this evolving audiology market. Our TPA team specializes in determining the most effective way for your practice to work with TPAs to ensure you remain successful. Using contract review and advisement, scheduling adjustments and employee training, you can take advantage of existing TPAs while our Access Hearing program provides an additional treatment option for patients that doesn’t compromise ongoing care and service.
TPA Contract Advising
Fuel provides contract review advisement to make sure you understand TPA contracts and defined benefits.
Every contract is different, so you’ll need to decide if you want to participate based on the reimbursement and what you’re required to do for the patient to get that reimbursement. If a practice provides services outside of the contract and doesn’t charge the patient directly for non-covered services, then the revenue loss is at the hands of the practice rather than the contract.
In today’s market, it’s not viable to offer your services without charge and still hope to maintain your practice. There’s no need to lower your service quality, but it’s important to educate patients and request payment for non-covered services.
Our team will empower you to make the informed decision that’s best for your practice.
How Fuel Helps: We’ll make sure you understand the TPA contracts you’re being presented with and choose the options that will best serve your practice.ke sure you understand the TPA contracts you’re being presented with and choose the options that will best serve your practice.
Keeping TPA Patients (through access hearing)
Fuel Medical created the Access Hearing Discount Program as a supplemental strategy for practices that have opted not to accept TPA plans. Access Hearing allows you to offer a full range of services that are accessible to all patients.
Access Hearing is not affiliated with any insurance plans. Instead, our team has contracted with manufacturers directly to allow practices to provide patients with a high-quality and affordable alternative to TPAs. The discount program was developed to offer price matching for those who have third-party benefits or are considering big-box retailers.
How Fuel Helps: Your regional team will walk you through our 7-step toolkit. We also offer professional development training to ensure every provider at your practice is prepared to walk patients through the Access Hearing Program.at TPA patients have covered versus what they don’t. We also provide collateral education development for your custom Access Hearing plans.