Helping Your Patients Upgrade

SONNET 3 is FDA approved and we know that many patients are eager to upgrade their processors. While product availability may take some time, patients are able to start the upgrade process now to ensure they receive their new SONNET 3 as soon as possible.

Eligibility

First, let’s start with who is eligible to upgrade. Insurance providers vary widely in their coverage of replacement devices. Typically, insurance will consider covering medically necessary processor upgrades when the replacement device is no longer under warranty AND one or more of the following circumstances apply:

1. The processor has met its reasonable useful lifetime, typically more than 5 years
2. The processor and components are no longer functional
3. The device is obsolete and no longer supported by the manufacturer
4. The recipients response to the existing processor is inadequate to the point of interfering with activities of daily living (ADL)
5. There is a documented lack of improvement in hearing performance and overall decline in user safety in challenging hearing environments
6. The processor is lost or stolen

It is also possible for your patient to skip the upgrade and insurance process altogether and buy the processor outright. If they prefer this option, they can contact our Customer Service department to place their order at customerservice.us@medel.com.

If your patients meet any of the six criteria above and they’d like to go through the insurance process, follow these steps to help your patients upgrade. You’re only responsible for the first two, MED-EL can help your patients through steps 3-5.

Step 1: Meet

If you haven’t seen your patients who are upgrade eligible in the past 6-12 months, please schedule an appointment with them. If your patient would like to file with their insurance company, most insurance companies require the patient to be seen within a year of the upgrade request. If you’d like to check the status of any of your patients, please feel free to call or email our customer service team. They’ll be more than happy to assist you.

Step 2: Complete

Once you’ve met with your patient, you’ll need to complete a letter of medical necessity. We can provide you a form to assist with this process. Some payers also require you to provide clinicals from the most recent appointment(s) to support the request.

Step 3: Submit

Our Customer Service team will need the following on file to proceed with placing your order.

• Completed Intake, Insurance, and Order Form
• Copies of the front and back of all current insurance cards sent to customerservice.us@medel.com

Have your patients fill out the order form with you, on their own, or with a member of our Audiology Technical Support Team. to help your patients understand what’s new about SONNET 3. They can attend our SONNET 3 MED-EL Monday to understand the features and basic handling before they receive their new processor.

Step 4: Verify

Once we have the letter of medical necessity, their order form, and insurance information, along with intake form or assignment of benefits if needed, MED-EL will verify your patient’s coverage and benefits.  Approval through insurance typically takes 4-8 weeks but may take longer depending on the insurance. We will keep your patient updated throughout the process. If the order is approved, your patient’s estimated cost share must be satisfied before we can ship your order.

Step 5: Ship

Once your patient has received approval from their insurance company, and has paid any remaining cost share, we can send it directly to the patient or to your clinic.

We are excited to help your patients through this process in order to receive MED-EL’s newest audio processor. Please use these same steps for your patients who would like to upgrade to SAMBA 2 or RONDO 3.