Patient Complexity Charge Matrix for Audiology Services: A New Perspective on Unbundling

Abstract

Traditional approaches to unbundling hearing aid services often take existing bundled charges and then separate the charges across all potential services associated with dispensing the devices. However, this method results in every patient being charged the same amount even though the complexity of the service varies across patients. We describe a model of charging for hearing aid services that takes into account three elements associated with patient services (i.e., assessing hearing status, audiologic decision making and interpretation, and counseling and treatment options) and two levels of complexity (straightforward and complex). Using this approach, there is negligible long-term financial impact on a practice however patients will perceive a lower overall cost for amplification. Additionally, this approach provides a payment structure more representative of the professional value of each visit.

Keywords

Value - audiologist expertise - patient complexity - reimbursement - unbundling

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