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Frequently Asked Questions

Disability Letters or Other Medical Form Requests

Dr. Syms will complete the form within the scope of the practice.  The form will be completed in terms of your ear. If the form requests information beyond your ear – it will not be completed.  For example, the ability to stand, ability to carry objects a certain distance, ability to sit for a period of time, etc. is information beyond the scope of ear care.

Disability determinations and other forms are not within the scope of the medical care Dr. Syms provides and are not an insurance reimbursable service. There is a minimum fee of $250 for this service. Fees must be paid at the time of the request.

Dr. Syms does not write letters without a form indicating the desired information and the justification for the request of the information. If a determination beyond the scope of ear problems, then this determination should be performed by your primary care physician.

Acceptance of the form is not a guarantee the form will be completed. The request I am submitted must be consistent with the medical record.  If the medical record does not reflect the request, the form will be returned without being completed.

Completed forms will only be sent back to you by mail. The arrival of the form can take 10 or more business days.  It will not be sent via email, scanned or faxed to any other party.

All requests must be submitted in-person along with a signed Medical Review form from our office. Please contact our office for more information.

How does the ear work?

First, sound enters the ear, bounces off the eardrum and passes through the three bones of hearing. The third hearing bone then interfaces with the cochlea (the hearing organ). Tiny receptor cells (also called hair cells) in the cochlea receive the sound, turn it into a nerve signal and send it to the brain for interpretation.

What if Dr. Syms is not in network with my insurance?

While we are contracted with most insurance, there are some we are not contracted with. Due to our specialty, we understand how difficult it can be to find a doctor who can serve your needs and accept your insurance. Therefore, we are happy to see patients who are out of network for us. We will need the proper insurance issued authorization with all of the necessary CPT codes to properly take care of you at your visit. Since most insurances require authorizations to see specialist be obtained by the primary care physician, we ask that you request this from your doctor. Please have them call us so that we can give them all of the necessary codes. Once the authorization is submitted, the insurance company has 14 business days to respond, but we have found that this process can be sped up by the patient calling the insurance as well. Once the authorization has been obtained, with all of the proper codes, we will be happy to schedule you to be seen.

How do I know if my appointment will be covered by my insurance?

We do our best to make sure you are eligible for services, we are in network, and all authorizations and/or referrals are in order prior to your appointment. Also, generally speaking, everything we do here in our office is covered by Medicare. However, per insurance guidelines, nothing is guaranteed on their part until the claim is received and processed, and all services are subject to medical necessity. Therefore, it is possible that something you have done in our office is only partially covered or not covered. This is a rare occurrence.

How does my insurance work?

Insurance can be a little confusing. Here is a basic run down of how insurance works:

If you have a deductible, generally your insurance will pay very little, if anything, until you have met that deductible. Once the deductible is met, you will generally have a co-insurance and out of pocket maximum. This means you will be responsible for a certain percentage of the billed fees until you have met your out of pocket maximum.

Each plan is different, so we will be happy to go over your specific benefits with you in detail.

How much does surgery cost?

This is completely dependent on your insurance, your network, and your particular plan. Each plan has different deductibles, co-insurances, out of pocket maximums, and exclusions. Before your surgery date, we will be calling your insurance to find out all of the specifics, and to obtain authorization for your surgery if needed. At that point, we will notify you to go over your benefits with you. Please keep in mind there are three separate entities for surgery: surgeon fees, facility fees (surgery center), and anesthesia.

I was told I was a cochlear implant candidate, why are we doing more testing?

Your initial hearing test suggests that you may meet the candidacy criteria for a cochlear implant. The only way to know for sure is to do more extensive testing with hearing aids on. Although the testing is performed in the sound booth, it entails different tasks from your initial test.

Why do I have to complete an audiogram? I just had one…

We want to ensure your hearing test delivers the most up-to-date results, thus allowing our board-certified specialists to treat your hearing loss properly and efficiently.

How long will it take for me to hear after the cochlear implantation?

Once the Cochlear Implant is turned on you will hear. It will often take time and training to understand what you are hearing.

How long is surgery for a CI?

Surgery is typically one and a half to two hours long; outpatient surgery allows you to return home that day. A patient’s pain is controlled with ibuprofen, and the CI will be activated the following week. To learn more about the Cochlear Implant candidacy process and journey to receiving the implant, please click here.

How expensive is it to have a cochlear implant inserted?

Typically Medicare will pay for one CI if the specific requirements have been met. Some insurances will pay for both ears to be implanted. Each insurance is different you should be aware of your specific insurance’s policy.

How do I know this is the right technology for me?

A specific test will be set up for you after your initial appointment. This appointment will be with the audiologist and is much more involved to determine if you are a CI candidate.

What is a cochlear implant?

A CI is a device that provides both volume and clarity for severe to profound hearing loss with poor understanding. Here is our Cochlear Implant Buyers Guide that can give you more information about the different options.

Will hearing aids make the ringing in my ears go away?

Having access to more sound will mask out the ringing and may make it so you do not hear the ringing. However, when the hearing aids are not in, you will likely still hear it.

My hearing aids help me quite a bit when I’m in one-on-one situations, but why do I have so much trouble hearing at restaurants and family gatherings?

Background noise makes communication more difficult for everyone, even those with normal hearing. The challenge is greater for those with hearing loss for a few reasons:

First, the sounds that make up the background noise overlap with the sounds of speech. Although some of the noise can be filtered out through the hearing aid, too much filtering would also filter out the speech.

The hearing loss takes away some of the ability to differentiate between small changes in pitch, so some of the cues we depend on to differentiate sounds are taken away.

Finally, in some situations, the noise is so significantly louder than the speech you are listening to that the noise just overpowers it.

Why do I need two hearing aids?

Our brains were designed to receive auditory input from two ears. When you have hearing loss in both ears, both should be rehabilitated. This will enable better hearing in noise and locating direction of sound.

Why are hearing aids so expensive?

The price of hearing aids includes not only the devices themselves, but the expertise of the audiologist, and all the follow-up visits and testing needed to appropriately care for your hearing loss.

How do I clean my hearing aids?

It depends upon the type of hearing aid you have. We’d be happy to guide you through the proper steps to cleaning your device!

How do you treat tinnitus?

Due to the personal and unique nature of each tinnitus condition, proper evaluation and specialized treatment is necessary. Although there isn’t a single cure for tinnitus, our audiologists are experienced at providing individual solutions on a case-by-case basis. After completing a hearing test, you may talk to an otolaryngologist for further examination.

What is tinnitus?

Tinnitus is a medical condition characterized by persistent ringing in one or both ears that can only be heard by the affected individual. It has also been described as whistling, hissing, buzzing, or pulsing in the ear. These sounds may come and go; however, most sufferers experience symptoms 24 hours a day, seven days a week. The effects range from slight annoyance to severe disruption of everyday life.

What are my options with an ear ache or an infection?

Ear infections occur in a variety of ways, and can happen internally, in the middle ear, or the outer ear. Because of the wide range of bacteria and viruses that can afflict different segments of the ear, it is important to pay special attention to the severity of your symptoms to help our specialists determine the correct course of treatment.

Our specialists will assess the health of the ear with an otoscope, looking specifically for fluid behind the eardrum and redness of the ear. Tone testing, such as an audiogram, or air-pressure tests like tympanograms, may also be performed to better understand the effects of the infection.

Antibiotics, antihistamines, decongestants, or ear-drops may be prescribed, and in some instances, ear-tube surgery may be recommended.

What is mixed hearing loss?

Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss (SNHL). In other words, there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as a mixed hearing loss.

What is sensorineural (nerve) hearing loss?

Sensorineural hearing loss (SNHL) occurs when there is damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain. Most of the time, SNHL cannot be medically or surgically corrected. This is the most common type of permanent hearing loss.

SNHL reduces the ability to hear faint sounds. Even when speech is loud enough to hear, it may still be unclear or sound muffled.

What is conductive hearing loss?

Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones (ossicles) of the middle ear. Conductive hearing loss usually involves a reduction in sound level or the ability to hear faint sounds. Oftentimes, this type of hearing loss can be corrected medically or surgically.

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