Download Hearing aid consumable services include

Audiology services/hearing aids
Purpose of the service
The purpose is to help claimants with hearing loss covered by ACC to lead as
normal a life as possible by regaining, acquiring or using the skills they need for
mental, physical, social or vocational function. Services include:

Audiogram report

Hearing rehabilitation assessment

Hearing needs assessment (hearing rehabilitation assessment and audiogram
report)

Hearing aid fitting

Hearing aid reviews

Hearing reviews

Hearing aid repair

Communication rehabilitation strategies.
Service objectives
The objectives of the service are:

Claimants have access to the most cost-effective treatment and rehabilitation
services that help the claimant to lead as normal a life as possible, having
regard to the consequences of his or her injury;

Presentation for the same or similar problem is minimised; and

ACC receives prompt and accurate information.
Audiogram report
The key objective of an audiogram report is to provide accurate information that
will assist ACC to determine:

Whether the hearing loss is typical of noise induced hearing loss or is
trauma induced, or

Whether the claimant’s hearing has deteriorated. The report will identify
the claimant’s degree of hearing loss, including any changes since the last
report.
Hearing needs assessment
The key objectives of hearing needs assessment services include:

Evaluating the nature and degree of a claimant’s communication difficulties in
activities of daily living that are a consequence of the loss of auditory function
covered by ACC, and

Providing timely assessment of the range of suitable rehabilitation options
including:

A claimant’s candidacy

Motivation and support for hearing aid use if applicable

A report with proposed options, and

The rationale for each option will be sent to the claims officer.
If an aid or aids are recommended, ear impressions are taken as necessary.
Hearing aid fitting, review and repair
The key objective of hearing aid fitting, reviews and repairs is to provide:

Hearing aid fitting, initial orientation

Hearing aid reviews

Hearing reviews, and

Hearing aid maintenance and repair.
How does a claimant access the services?
Audiogram report
The criteria for access to an audiogram report described in this Schedule are that
the provider has either:


Received a referral from:

An otolaryngologist; and

An ACC45 has been lodged by a medical practitioner; or in the case of
foreign bodies in the ear by an audiologist or a medical practitioner; or
Received a referral from:

A claims officer for a hearing needs assessment; and

The referral is for both a rehabilitation assessment and an audiogram
report.
Hearing needs assessments and hearing aid fitting/reviews
(trial purposes)
The criteria for access to hearing needs assessment services and hearing aid
fitting and reviews (for the purposes of trialing a hearing aid) described in this
Schedule are that:

The provider has received a referral from a claims officer for a hearing needs
assessment or for a hearing aid trial requiring hearing aid fitting and hearing
aid reviews.

ACC will not pay for services unless this requirement is met.
Hearing aid review, hearing review and hearing aid repair
The criteria for access to a hearing aid review, hearing review or hearing aid
repair described in this schedule are that:

The claimant needs this service as a direct result of hearing loss that is a
personal injury covered by ACC, and

The hearing aid was purchased by ACC.
Claimants may self refer for hearing aid repair and hearing reviews.
Qualifications required
The provider will utilise the services of only the named audiologists in the course
of providing services for claimants, except that an appropriately qualified
technician supervised by a named audiologist may provide on-site hearing aid
repair services.
All audiologists providing services for the provider must be a full member of the
New Zealand Audiological Society, have a Certificate of Clinical Competence and
adhere to the Code of Ethics.
This does not include a member when he or she is acting in the course of
employment by a supplier of hearing aids.
What does the service involve?
Appointments
For all services the provider will arrange any necessary appointments with the
claimant.
Audiogram report
On referral from an otolaryngologist or a claims officer the audiogram report
includes:

Audiological history

Pure tone audiogram (PTA) air and bone conduction with masking where
clinically appropriate

Middle ear function test

Infection control procedures

Speech test

Results collation

Report in the format specified using an ACC 22(a).
The provider must ensure that all matters pertaining to the audiogram report
comply with the Accident Compensation Act 2001, the Accident Insurance
(Occupational Hearing Assessment Procedures) Regulations 1999 including
ISO6189 standards, as well as all ethical and professional standards related to full
membership of the New Zealand Audiological Society.
Hearing needs assessment
The hearing needs assessment report includes all the information specified and is
provided to ACC in the required format. Proposed rehabilitation options identified
to assist a claimant who needs rehabilitation as a result of personal injury may
include recommending that ACC provide services such as:

Hearing aid(s) – type and approximate cost

Other hearing device

Communication rehabilitation skills programme.
Referral for other services
Hearing needs assessment services may include:

An audiogram report, if this is requested by the claims officer, and

A rehabilitation assessment including:


Introduction

Recording the history of physical, psychological, communicative and socioeconomic variables

Otoscopy and minor cerumen (wax) management

Discussing results and implications of the audiogram report

Interviewing and administering assessment tools as appropriate, eg,
Hearing Handicap Inventory, Abbreviated Profile of Hearing Aid Benefit

Discussing with the claimant their hearing requirements in the home,
social, educational and employment environments

Identifying any difficulties in activities of daily living, and the reasons for
these

Identifying the range of rehabilitation options likely to assist the claimant
with these everyday difficulties, and the reasons for any preferred options;
If hearing aids are assessed as a suitable rehabilitation option, then:

Determine the management capability and support for aid handling

Investigate motivation for aid and acceptance of loss and hearing aid use

Educate regarding hearing aid benefits and limitations

Discuss the financial aspects and outlining trial requirements

Recommend aid model and style and binaural or monaural

Recommend appropriate additional features, eg, telecoil and assistive
devices

Determine whether medical clearance is necessary before impression
taking proceeds

Take ear impressions if necessary

Dictate reports and update file

Complete hearing needs assessment report in full in the required format
and send to the claims officer for a decision on entitlement.
Hearing aid fitting and review
This service will be provided on referral from a claims officer as part of the
rehabilitation process. The hearing aid fitting and review services include:
Hearing aid fitting
The hearing aid fitting process requires that the fitted hearing aid meets with the
manufacturer’s objective specification levels for that model, and also that the
claimant’s objective and subjective result levels meet the standards of
audiological best practice. A hearing aid fitting includes providing sufficient
information for the claimant/caregiver to use and care for the aid correctly.
On approval from the claims officer for a hearing aid trial, the provider is
responsible for ordering the recommended aid.
Services can include any or all of the following as per audiological best practice:

Ordering the recommended hearing aid

Forwarding ear impressions to the manufacturer

Recording on chart

Schedule appointment

Calculate required gain over the frequency spectrum 250-4000 Hz

Ensuring hearing device arrives at least one day before the scheduled
appointment

Run through standard test box measures, eg, SSPL 90 and check the
harmonic distortion levels

Making a physical check that aid is complete and batteries are correct

Having client’s record and hearing devices ready on the appointment day

Checking the aid’s physical fit and adjusting as necessary

Measuring unaided real-ear responses

Aid setting and outcome measured on real-ear instrument and adjusting as
required

Subjective rating of performance with and without hearing aid

Free-field measures

Initial programming finalised and noted

Information on use, care, storage, expectations, trouble-shooting, assistive
devices, battery purchase and disposal

User booklets provided as part of the rehabilitation process

Demonstration and practice on insertion/extraction, volume use and telephone
use

Target wearing schedule discussed

Discuss strategies for specific difficult situations

Hearing aid serial numbers, warrant expiry recorded

Further appointment made if required.
Hearing aid reviews (adjustment and final)
This service will include adjustment and final hearing aid reviews to ensure the
aid is functioning to specification, verify its effective use, adjust the parameters
as necessary, provide education in aid management and specific difficult
situations. Services include:

Checking the physical comfort and insertion

Subjective rating of performance with and without hearing aid

Adjusting parameters if necessary and re-checking the gain on real-ear

Analysing user schedule and battery life

Checking mechanical use of volume, switch and battery door

Reviewing telephone and telecoil use

Checking removal and storage actions

Testing electroacoustically or subjective stetoclip

Continuing education for use, including trouble shooting

Interviewing and administering post-fitting assessment tools as appropriate,
eg, Hearing Handicap Inventory, Abbreviated Profile of Hearing Aid Benefit,
Hearing Aid Performance Inventory

Arranging further hearing aid orientation as required

Documenting costs for insurance purposes

Finalising payment details and invoice as appropriate

Updating chart

A hearing aid confirmation of successful hearing aid trial (ACC324) must be
fully completed by a full member of New Zealand Audiological Society 1 and the
claimant and sent to ACC at the successful conclusion of a hearing aid trial.
Aids may be trialed for up to six weeks per set of aids. The audiologist may, if
necessary, provide additional hearing aid reviews within six weeks of completion
of a successful hearing aid trial to ensure the aid’s optimal use.

Where the claimant requires more than one hearing aid trial and the aid type
and model recommended for any second or subsequent hearing aid trial is
substantially different from the recommendation in the hearing needs
assessment, the provider will seek approval from the claims officer or case
manager, including the specifications of the new hearing aid and why, in the
opinion of the provider this change is necessary and appropriate to meet the
claimant’s assessed injury related needs. The second or subsequent hearing
aid trial will only proceed if ACC approves such a trial.

ACC will not consider purchase of aid(s) without receiving the fully completed
ACC324 form at the conclusion of a hearing aid trial, (including the quantity of
batteries required in the next 12 months, based on recorded trial usage).
Batteries will be supplied directly to the claimant under existing national
supply contracts.

The hearing aid will be supplied in working order with one month supply of
batteries.
Hearing review
Claimants may self-refer if they are experiencing new difficulties in everyday
activities related to their hearing loss.
Only an audiologist who is a full member of the NZAS can be funded by ACC for
hearing aid consultations. This is subject to the following:
1
~A member of NZAS cannot be funded by ACC when action in the course of
employment by any supplier of hearing aids or acting as a supplier of hearing aids
~If a provisonal member of the NZAS is involved in the providing the hearing aid
trial and the member of NZAS remains in the room with the provider and claimant
for the duration of the service the audiologist who is a full member of NZAS can
claim for the service

Services include:

Recording clinical history from interim period

Gain subjective evaluation from claimant taking into account effect of the
ACC-related hearing loss on activities of daily living

Check ear canals are healthy

Pure tone audiometry and speech if cognitive risk

Middle ear check

Visual check of aid and earmould fit

Biofeedback or habituation therapies if required

A brief report to the claims officer outlining findings and any further
investigations or assessment recommended, including the reasons for any
recommendations.
Hearing aid repair
Claimants may self-refer to ensure their hearing aid is functioning to specification.
Repair refers to any restoration of a hearing aid to improve the condition of the
aid to allow improved current usage. This may include cleaning, consumable
replacement, the need for off site repairs by the manufacturer or agent, and/or
pinpoint the need for a formal appointment to make electroacoustic adjustments,
replace ear moulds or reshell in ear aids.
Fault finding services include:

Visual check of aid and ear mould fit

Otoscopy

Determine whether aid requires repair on site or off site

Arrange for cleaning.
Hearing aid consumable services include:

Repairs completed on site requiring consumables such as battery doors, wax
guards and tone hooks.

Off-site repairs include:

Send for repair off site

Repair invoice sent to the claims officer for verification and payment

Arrange follow-up appointment when aid repaired.

Repairs over $200 (excl-GST) will include the wholesale invoice. For all
hearing aid repair services, the invoice is sent to the claims officer when
repairs are completed. Levels of fault finding and consumables will be
monitored. The claims officer may request information to substantiate
requests outside acceptable practice profiles.

ACC will not pay for repairs within the warranty period of the hearing aid.
Repairs are provided as required by the claimant and will be monitored by the
claims officer.
No additional payments for treatment or rehabilitation
The specified prices are the total prices payable in connection with the services,
and the provider is not entitled to any payment or reimbursement from the
claimant or any other person, including payment of any additional or excess or
part charge, for any of the services provided under this Agreement.
When additional payments permitted
The provider may receive payment from the claimant for any additional or excess
or part charge if the claimant, having been provided with all relevant information
by the provider, wishes to purchase a hearing aid which is more expensive than
the hearing aid which is necessary and appropriate and of the quality required for
the purpose of meeting the claimant’s assessed needs.