ComplaintsforCochlear Americas

• Initial Complaint

  02/27/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I've been trying to get a new sound processor since November. It is now February. Cochlear has been awful to deal with; it takes months for the company to get insurance approval. This is unacceptable. The worst part is, Cochlear won't tell the truth. Every time I called and asked, they couldn't tell me how much longer it would take. The standard answer is, it takes 6 weeks. So they took my money and I can't get in til the end of March to see the audiologist

  Business response

  03/08/2024

  Cochlear Americas (Cochlear) appreciates the opportunity to respond to the issue raised in the above-referenced complaint initiated by the Customer.
  
  Company Background:
  ********************** is the global leader in innovative,implantable hearing solutions and distributes the Nucleus cochlear implant system. This remarkable technology provides individuals who experience severe to profound hearing loss with access to sound. The cochlear implant system consists of two components: an internal/implantable component, and an external component. The external component picks up sound through a microphone, translates that sound into electronic impulses and passes the sound to the internal/implanted component through a cable coil and magnet. The internal component is implanted into a patients cochlea (inner ear) by his/her surgeon, and its function is to receive the electronic impulses transmitted by the external component and stimulate the hearing nerve so that the recipient can hear. Recognizing that cochlear implant patients will have their device for the rest of their lives, and thus have a lifelong relationship with the Company, Cochlear strives to provide its recipients with superior customer service, and we are disappointed to hear that we have fallen short of meeting the Customers expectations. 
  

  The Review:
  I've been trying to get a new sound processor since November. It is now February. Cochlear has been awful to deal with; it takes months for the company to get insurance approval. This is unacceptable.The worst part is, Cochlear won't tell the truth. Every time I called and asked, they couldn't tell me how much longer it would take. The standard answer is, it takes 6 weeks. So they took my money and I can't get in til the end of March to see the audiologist
  
  Timeline of events:
  We received a request from the Customers Audiologist on 12/04/2023 to place a Baha 6 ******************* upgrade. On 01/08/2024 we sent the Letter of Medical Necessity request to the Audiologist and the Customers ENT doctor. We received the completed Letter of Medical Necessity on 01/29/2024 and started the Authorization process. We sent the co-insurance information to the Customer and received the payment from the Customer on 01/30/*************** to the *************************** for the Authorization were done by Cochlear via phone calls on 02/01/2024, 02/05/2024 and 02/06/2024.  Our process is to wait for the paper authorization from the insurance company before we can complete the order and ship. We received written Authorization from the insurance company via facsimile on 02/08/2024, however, it was not completed correctly by the insurance company.We made a phone call to the insurance company and outlined what needed to be revised on the Authorization. We received the revised Authorization from the insurance company on 02/09/2024 and order was shipped on 02/09/2024.
  In reviewing interactions from Cochlears customer service department, the Customer called ********************** on **/16/2024, 01/28/2024, 02/04/2024, and 02/05/2024 for status updates. The customer service representatives provided updates to the Customer based on where the order was in the process, which included collecting the required clinical documentation from the Customers Audiologist and ENT doctor and obtaining written Authorization from the ***************************.
  
  Resolution:
  Cochlear understands the frustration associated with the processing of the order through the Customers health insurance company and obtaining the Authorization from the ******************** We understand the processing time of the order did not meet the expectations of the Customer and have identified a gap from 12/04/23-01/08/24, which was a processing error. During the investigation, the patient provided us with details of their secondary insurance ****************** plan, which means they should not have been charged co-insurance. We issued a full refund to the patient. We have contacted the Customer and informed her that a full refund was issued.

• Initial Complaint

  11/29/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On August 8, 2022, I underwent surgery to receive a Nucleus 8 cochlear implant to address hearing loss in my left ear. The implant incorporates a removable processor device, equipped with a rechargeable battery that I diligently charge every night. Additionally, Cochlear provided a dedicated app via the App Store, installed on my iPhone. This app includes a feature enabling the tracking of the processor's location.Regrettably, on September 21, 2023, my processor went missing, and despite exhaustive searches, I have been unable to locate it. Notably, the "Find My Processor" feature ceased functioning on September 4, 2023, at 5:37 PM, unbeknownst to me until after the processor went missing.Efforts to resolve this issue with Cochlear Americas' technology department have proven unsuccessful. Despite a telephonic conversation on October 30, 2023, at 3:06 PM, they declined my request for assistance. While I am entitled to one free replacement, I am hesitant to utilize this benefit, as the malfunctioning app is the primary hindrance to locating the missing processor.I have reached an impasse with Cochlear's tech department, as they have been unable to rectify the problem with the app's location feature. In light of these challenges, I kindly request Cochlear Americas to provide a replacement processor without depleting my one free replacement benefit, considering the extenuating circumstances surrounding the malfunctioning app.

  Business response

  12/11/2023

  Company Background:   
  Cochlear is the global leader in innovative, implantable hearing solutions and distributes the Nucleus cochlear implant system.  This remarkable technology provides individuals who experience severe to profound ******** with access to sound.  The cochlear implant system consists of two components:  an internal/implantable component, and an external component.  The external component is worn either behind the recipients ear (*** or behind the ear model) or attached to a belt or in a pocket (body-worn model), and its function is to pick up sound through a microphone, translate that sound into electronic impulses and pass the sound to the internal/implanted component through a cable coil and magnet.  The internal component is implanted into a recipients cochlea (inner ear), and its function is to receive the electronic impulses transmitted by the external component and stimulate the hearing nerve so that the recipient can hear.  
  Recognizing that cochlear implant patients will have their device for the rest of their lives, and thus have a lifelong relationship with the Company, Cochlear strives to provide recipients with superior customer service, and we are disappointed to hear that we have fallen short of meeting the Customers expectations. As explained below, when made aware by the Customer of his concerns, the Company took what it views to be prompt and appropriate action to address the issues identified. 
  
  Specific Issues: 
  The Customers complaint involves two aspects with respect to Cochlear: (1) The find my processor app does not function as the customer expected (2) the processor was lost, and the customer does not want to use the lost & damage claim process to replace it.  Both of these issues are addressed more specifically below. 
  
  Timeline: 
  Cochlear was first made aware of the Customers concerns in September of 2023, when Cochlears *************************** received a call from the Customer wherein he indicated his processor was lost and he requested help with the Find My Processor App.  Specifically, the app was pulling his location from a few weeks prior.  He expressed frustration that the app did not pull the current location of his lost processor. The proper functionality of the app was explained to the customer: our processor does not contain a tracking chip, rather it uses the internet connection to trace where it was last connected through a smartphone. This means that, to Cochlear's knowledge, the Customer's sound processor had not been connected to the internet or his smartphone for the weeks before it was lost, and therefore the Find My Processor app was unable to provide a more recent location. We offered at that time to replace the processor through our lost & damaged (L&D)claim process (each of our Recipients is entitled to one no cost replacement per new system or upgrade processor).  The customer declined. He then proceeded to contact us a 2nd time, where in the app was again explained and an offer to start the L&D process was extended. He again declined.  At the end of October, Cochlear Legal team received a letter from an attorney claiming to represent the Customer, inquiring about our process/handling of the Customers complaint, and asking us to work directly with the Customer to resolve the dispute.  A Supervisor within our **************** Device Support team contacted the Customer, spoke with him, and again explained how the app functioned and offered to replace the processor using the L&D claim process. Customer declined the option of initiating a L&D claim. 
  
  Resolution 
  Based on a detailed review of the complaint and Cochlears records, Cochlear resources appeared to have explained how our Find My Processor app works and provided options for a free of charge replacement i.e., filing a lost claim. On 12/7/2023, we attempted to contact the Customer to again offer to replace the processor as his lost claim.  A phone message was left with request to call us back or email confirmation to start the L&D claim process.

  Customer response

  12/11/2023

   
  Complaint: 20936349
  
  I am rejecting this response because:
  
  The processor was always being charged every single night, always on WiFi and the data on the cell phone where the nucleus smart app is installed have the data on. Even if I agree to avail my one time free replacement what is the guarantee that App might stop working without my notice. The cochlear company is not willing to accept that there was a glitch in their app and it is costing me so much agony and frustration. They keep telling me that it is my fault which is absolutely ridiculous. 
  
  Sincerely,
  ***************************

• Initial Complaint

  05/05/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Ive had a BAHA since 2008. It is a medical necessity for hearing. The surgery was covered under insurance. The second devic was cover under insurance and through financial assistance. Its time for a new processor cochlear retired it. I have been asking for assistance in a new processor. I receive many emails and snail mail, I get many different answers, no one person as before. Cochlear has become overwhelming to work with and if my old processors get damaged or stop working i am stuck with a connectable titanium post sticking out of the right side of my head with nothing to place there. It surgery to get it or to remove. I dont want to remove it. Im frustrated that this is occurring and if I knew in the first place would have never had surgery.. please I need assistance from someone whos not throwing me around MEDICALLY NECESSARY PROCESS

  Business response

  05/15/2023

  Company Background: 
  
  Cochlear Americas (Cochlear)appreciates this opportunity to respond to the issue addressed
  in the above-referenced complaint initiated by the Customer.
  
  Our mission
  We help people hear and be heard.
  We empower people to connect with others and live a full life.
  We help transform the way people understand and treat hearing loss.
  We innovate and bring to market a range of implantable hearing solutions that deliver a lifetime of hearing outcomes.
  
  We are disappointed to hear that ************************ experience has not met her expectations and hope that we can provide some clarity on this situation.
  
  Complaint Involves:
  Repair Issues
  
  Customers Statement of the Problem:
  Ive had a BAHA since 2008. It is a medical necessity for hearing. The surgery was covered under insurance. The second devic was cover under insurance and through financial assistance. Its time for a new processor cochlear retired it. I have been asking for assistance in a new processor. I receive many emails and snail mail, I get many different answers, no one person as before. Cochlear has become overwhelming to work with and if my old processors get damaged or stop working i am stuck with a connectable titanium post sticking out of the right side of my head with nothing to place there. It surgery to get it or to remove. I dont want to remove it. Im frustrated that this is occurring and if I knew in the first place would have never had surgery.. please I need assistance from someone whos not throwing me around MEDICALLY NECESSARY PROCESS
  
  Desired Settlement:
  Other (requires explanation)
  Contact by the business; Delivery 
  
  HIPAA: HIPAA Release was offered and accepted on 5/5/2023.
  
  Resolution:
  Cochlear Americas spoke with ************************ on 5/12/2023 regarding this complaint; she expressed frustration pertaining to communication with various Cochlear departments. ************************ is sharing details so that we may review and address her questions and concerns with the process and the service she has received. One of our Cochlear supervisors shared escalation details and points of contact for future use to better support ************************ going forward. At the conclusion of the call, ************************ understood, and communication concerns were resolved. Cochlear is continuing to provide support for her pending order. 

  Customer response

  05/15/2023

   
  Complaint: 20022256
  
  I am rejecting this response because:
  
  Sincerely,
  
  *****************************

  Customer response

  05/17/2023

  I spoke with BCBS
  
  There was something that wasnt handled correctly 
  
  When the agent  requested for  the co-Insurance information the following wasnt mentioned :
  
  Durable *************************************Insurance 
  
  Medically Necessary 
  
  ************************;
  ************
  *******************

  Customer response

  05/19/2023

  I spoke with insurance 
  
  
  There was something that wasnt handled correctly 
  
  
  When the agent  from cochlear requested the Insurance information the following wasnt mentioned :
  
  that this would be considered 
  
  Durable Medical Equipment 
  
  So therefore the insurance company would have a 
  No Co-Insurance 
  
  because this device has an implanted titanium s**** and the nw processor can be requested every 5 years
  and it is 
  Medically Necessary 

  Business response

  06/05/2023

  Cochlear Americas is an out-of-network provider with Ms. *********** insurance plan through Florida Blue Shield. ************************ s was provided an estimated out-of-pocket cost that denoted a deductible amount and a $0.00 coinsurance amount before placing her durable medical equipment order for a Baha 6 ********************  She was notified in writing that an exact out-of-pocket cost amount could not be calculated until the order shipped and the claim was processed by her insurance company.  Cochlears Reimbursement and Insurance team requested consent from ************************ to continue to process her order through her insurance plan. Ms. *********** provided signed consent and acknowledgement that any amount not covered by her insurance plan would be her responsibility and that the amount quoted was an estimate and not a guarantee of out-of-pocket expense.  
  
  Cochlears Reimbursement and Insurance team then sought a Letter of Medical Necessity from Ms. *********** physician but was unsuccessful in securing such due to a lapse in her care.  Ms. *********** was notified in writing of the need to re-establish care with her physician, and she has since notified Cochlear that an appointment has been scheduled for July 7, 2023. 
  
  Upon completion of July 7,2023 appointment, Cochlears Reimbursement and Insurance team will re-attempt to obtain a Letter of Medical Necessity from Ms. *********** physician, as well as a Prior Authorization and an In-Network Exception with her insurance plan Florida Blue Shield, for the medically necessary durable medical equipment.  Cochlears Reimbursement and Insurance team has confirmed with Florida Blue Shield that durable medical equipment benefits are NOT subject to the members deductible for in-network providers,therefore if Ms. *********** insurance plan agrees to provide prior authorization and an in-network exception for Ms. *********** durable medical equipment order, this level of benefit will indeed apply.

• Initial Complaint

  04/17/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  03/13/2023 my last straw with cochlear America was broken. I called in because I was advised that my son was eligible for an equipment upgrade since the new n8 processor was out. I called cochlear America and the first rep told me only one side was eligible, called again another rep said he wasn't eligible period, called several more times got several more answers so at this point I ask to speak to a supervisor. Supervisor gets on the line but is of no help whatsoever. They never are! Anytime I need a replacement part for my son's devices they always give me such a difficult time and run around. I literally have to call someone at the university to call In and handle the situation for me, which Is not their job to do. Thank goodness for them going out of their way because if not my son would have no hearing. Then on April 15th some unnamed individual had the nerve to say I hung up on them and never called back when in reality the supervisor they put on the line was just as unable and unwilling to resolve the issue as the representatives were. They lied saying guidelines were specified. NO guidelines were specified during the call, she basically said poor children don't deserve to hear, but if they want to disguise it behind ******** go ahead. Also for reference the whole call was on speaker and the doctors at the clinic were also disgusted by the way my calls were handled. Funny thing is as I stated the clinic called themselves and magically new parts show up at my door step. Which as I stated if the clinic doesn't call i get no service.

  Business response

  04/27/2023

  Cochlear Americas (Cochlear)appreciates this opportunity to respond to the issue addressed in the above-referenced complaint initiated by the Customer.
  
  In conversation with ********************,we discussed communication with Cochlear and opportunities for improvement.Additionally, we reviewed ******** coverage guidelines specific to sound processor replacements and ensured she is aware of options available to keep her child in sound. Cochlear is committed to providing ongoing support to ******************** and as such shared contact information, remaining by our brand promise to be 'Hear Now and Always'. 

• Initial Complaint

  03/28/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  03/13/2023 my last straw with cochlear ******* was broken. I called in because I was advised that my son was eligible for an equipment upgrade since the new n8 processor was out. I called cochlear ******* and the first rep told me only one side was eligible, called again another rep said he wasn't eligible period, called several more times got several more answers so at this point I ask to speak to a supervisor. Supervisor gets on the line but is of no help whatsoever. They never are! Anytime I need a replacement part for my son's devices they always give me such a difficult time and run around. I literally have to call someone at the university to call In and handle the situation for me, which Is not their job to do. Thank goodness for them going out of their way because if not my son would have no hearing.

  Business response

  04/05/2023

  Cochlear Americas (Cochlear or Company) appreciates this opportunity to respond to the issue addressed
  in the above-referenced complaint initiated by the ********.
  
  Company Background:
  
  Cochlear is the global leader in innovative,implantable hearing solutions and distributes the
  Nucleus cochlear implant system.This remarkable technology provides individuals who
  experience severe to profound hearing loss with access to sound. The cochlear implant system
  consists of two components: an internal/implantable component, and an external component.
  The external component picks up sound through a microphone, translates that sound into
  electronic impulses and passes the sound to the internal/implanted component through a cable
  coil and magnet. The internal component is implanted into a patients cochlea (inner ear) by
  his/her surgeon, and its function is to receive the electronic impulses transmitted by the
  external component and stimulate the hearing nerve so that the recipient is able to hear.
  Recognizing that cochlear implant patients will have their device for the rest of their lives, and
  thus have a lifelong relationship with the Company, Cochlear strives to provide its recipients
  with superior customer service,and we are disappointed to hear that we have fallen short of
  meeting the ********s expectations.
  
  The Complaint:
  ********s Statement of the Problem:
  03/13/2023 my last straw with cochlear America was broken. I called in because I was advised that my son was eligible for an equipment upgrade since the new n8 processor was out. I called cochlear America and the first rep told me only one side was eligible, called again another rep said he wasn't eligible period, called several more times got several more answers so at this point I ask to speak to a supervisor. Supervisor gets on the line but is of no help whatsoever. They never are! Anytime I need a replacement part for my son's devices they always give me such a difficult time and run around. I literally have to call someone at the university to call In and handle the situation for me, which Is not their job to do. Thank goodness for them going out of their way because if not my son would have no hearing.
  

  Desired Settlement:
  Contact by the business
  

  Resolution:
  Cochlear Americas spoke with the members mother (*******************) on March 13, 2023 regarding wanting to upgrade her sons sound processors.  During the initial call ******************* was provided general guidelines for sound processor upgrades.  Unfortunately, before discussing any further details, this call was lost.  When ******************* called back, she was connected with a Cochlear ******** Service Supervisor who advised that based on ********s guidelines, her son was not eligible for upgrades on either side, at this time.  ********************* sons processors are still under warranty, Cochlear explained that processor exchanges could be facilitated but upgrades to Cochlears newest Nucleus 8 sound processor could not.  ******************** acknowledged she understood that, because of ******** guidelines/criteria, her son is not eligible for an upgrade(s) at this time and discontinued the call by hanging up. 
  Cochlear Americas ******** Service Supervisor promptly called ******************** back but had to leave a voice message requesting that ******************** return her call and ask to speak directly with her.  No return call has been received from *******************. Upon notification of this complaint, Cochlear contacted ******************** again to discuss and reiterate payor guidelines. We have not heard back from her, but we remain available and willing to assist *********************

  Customer response

  04/05/2023

   
  Complaint: 19862138
  
  I am rejecting this response because: it's a lie. I hung up because the supervisor sounded just as uninformed as the several reps I spoke to before her. And guidelines weren't specified during the call, she basically said poor children don't deserve to hear, but if they want to disguise it behind ******** go ahead. Also for reference the whole call was on speaker and the doctors at the clinic were also disgusted by the way my calls were handled. Funny thing is as I stated the clinic called themselves and magically new parts show up at my door step. Which as I stated if the clinic doesn't call o get no service so what's the point of making it seem like you all care or service the people?  Cochlear ******* is trash 
  
  Sincerely,
  
  ***************************

• Initial Complaint

  03/22/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I am receiving multiple email demands from Cochlear to pay $******* over their original payment request. I have phoned Cochlear but am unable to reach a customer representative; my requests for a call back are ignored.In 2022 I received a notice from Cochlear that my ****5 device would no longer be supported & offered to upgrade me to a ****6. I responded & asked for more information. When I received my ****5 at *************************, the device was covered by my insurer, ************ of ************* (BC/BS).After several extended conversations with a Cochlear representative ************************************* I obtained, as Cochlear requested, a Letter of Medical Necessity & other information from my doctor at *************************. The Cochlear representative also spoke directly with my surgeon's office and insurer.I then received a request from Cochlear to pay $2518, which I paid. Cochlear now claims I owe an additional *******. This seems to be an attempt to press me to cover for their mistakes or misrepresentations in their original estimate. I've asked Cochlear (via email since I am unable to reach them by telephone) to review their submission to my insurer, since my previous Cochlear device (**** 5) was covered by my insurer and because my insurer covers prosthetic devices. (And according to Cochlear's own website, the **** is a prosthetic device.)I suspect the problem is that Cochlear did not submit the claim correctly on my behalf. Unfortunately, my insurer, ************ of ************* tells me that b/c of a system upgrade I have no access to details of any claims, and will not for several weeks.I ask BBB to get Cochlear to check their submission to my insurer, correct any errors, & resubmit their claim or (b) admit their original estimate was misleading. I purchased the ****6 based on my faith in Cochlear's guidance, documentation, and assurances from their representative that their estimate was accurate. I will not pay for their mistakes or for a misleading estimate.

  Business response

  03/30/2023

  Cochlear Americas was an out-of-network provider with Ms. ********* insurance plan through *************************** of Massachusetts. ******************** was given an estimated out-of-pocket cost of $2,518.40 before placing her **** 6 *** ****** She was notified in writing that Cochlear was an out of network provider with her health plan and because of this an exact out-of-pocket cost amount could not be calculated until the ***** shipped and the claim was processed by her insurance company. Cochlears Reimbursement and Insurance team requested consent from ******************** to continue to process her ***** through her insurance plan. ******************** provided signed consent and acknowledgement that any amount not covered by her insurance plan would be her full responsibility and that the amount quoted was an estimate and not a guarantee of out-of-pocket expense.
  Cochlears Reimbursement and Insurance team sought an In-Network Exception and One-Time Agreement with *************************** of Massachusetts, but this request was denied, and we notified ******************** of the denial in writing.  Cochlear recommended ******************** call her insurance plans ************************** and request a One-Time Agreement. In the meantime, ******************** paid the estimated out-of-pocket cost of $2,518.40, provided signed authorization to release the ***** without a One-Time Agreement, and accepted financial responsibility for any and all amounts owed that were not covered by her insurance company.
  Cochlears Billing and Collections team filed the insurance claim with *************************** of Massachusetts after Ms.********* **** 6 *** ***** was shipped, consistent with protocols and as we explained to ******************** previously. Nearly four months later, *************************** of Massachusetts issued a claim payment of $686.40 to Cochlear and ascribed $5,308.60 to patient responsibility ($750 in deductible, $171.60 in coinsurance, and $4,387.00 in non-covered charges). Cochlears Billing and Collections team reviewed the outcome of the claim and contacted *************************** of Massachusetts. The **** 6 *** claim processed under Ms.********* plan coverage for Durable Medical Equipment as determined by *************************** of Massachusetts, and the coverage for Durable Medical Equipment or Prosthetic/Orthotic Device were identical under her plan. Without an In-Network Exception and One-Time Agreement, *************************** of Massachusetts paid the claim out-of-network and allowed less than 27% of billed charges for the **** 6 ***. As an out-of-network provider, Cochlear was advised that only the member ******************** could appeal the claims determination.
  ******************** was invoiced $2,790.20, since she paid $2,518.40 before the ***** shipped.  Cochlears Patient Collections team made four attempts to contact ******************** via phone and email to discuss resolution options but was unable to reach her. Cochlears Patient Collections team provided ******************** with a direct extension to a team member qualified to assist with the patient responsibility determined by her insurance. ******************* remained unresponsive until her email notifying the team that she had filed a complaint with the BBB. Cochlears Patient Collections team continues to be available to ******************** to discuss the best applicable options to resolve her balance.

  Customer response

  04/03/2023

   
  Complaint: 19635401
  
  I am rejecting this response because:

  1) It is inaccurate I've been unresponsive--I've phoned Cochlear each time they left a message but have yet to get through to anything more than the automated service that lets me leave a call-back number. Call-backs always come during my working hours when I am not near my personal phone.

  2) I am requesting Cochlear send me by email -- not ****** the copy of their correspondence to me re: the denial from BBA and request that I call BBA to request a One-Time Agreement. I did not receive this correspondence, and the Cochlear representative with whom I had multiple conversations about this never mentioned it. As I  made plain in my multiple phone conversations with this same Cochlear representative, $2500 was the maximum I would be able to pay for this device.

  In the meantime I am contacting BBA to see why this device was covered in 2018 and not in 2022. 

   

  
  Sincerely,
  
  *****************************

  Customer response

  04/05/2023

  I have new information on my existing complaint again Cochlear Americas.
  
  Ive been unable to reach Cochlear (though I will try again) by phone after work today.
  
  I spoke with my insurance company early this morning, and they said the reason they did not cover the claim for the Cochlear devices is because the claim was incorrectly submitted by Cochlear. 
  
  In 2018, Cochlear did not file the claim direction with **************** Shield, but ran it through my hospital/surgeon (**********************************). In 2022, Cochlear filed the claim directly instead of filing through *************************. I am unsure why they proceeded this way b/c they were in touch with my hospital/surgeon in order to get a letter of medical necessity for the 2022 replacement device.
  
  Blue Cross/Blue Shield said that IF they had in 2022 filed correctly (through *************************) the device wouldve been covered, because ************************* is in network (while Cochlear is not).
  
  Cochlear needs to file correctly, going through my surgeons or the ******* billing office. 
  
  Could this new information be added to the claim correspondence on your site (for Cochlears benefit but also for future consumers who have this difficulty)? I am unable to find a way to add this information myself.
  
  Thank you,
  
  *****************************, PhD [she/her]
  **************************
  PO Box 4423
  Vineyard Haven, ** 02568
  Connect with me at LinkedIn: *******************************************
  

  
  

  Business response

  04/12/2023

  Cochlear Americas (Cochlear)appreciates this opportunity to respond to the additional information provided by the Customer to the above-referenced complaint.
  
  ******************** was notified in writing that Cochlear was an out-of-network provider with her health plan *************************** of Massachusetts before the ***** for her Baha 6 *** was placed. Despite Cochlears out-of-network status, ******************* elected to proceed with the placement of the ***** by authorizing the ***** in writing on 05/02/2022. The ***** was placed on 05/04/2022.
  
  Cochlear continued to notify ******************** in writing about the impact of Cochlears out-of-network status during the twelve weeks before her ***** shipped. ******************** provided signed Assignment of Benefits, authorizing Cochlear to bill her insurance directly, and requesting that her insurance provider make payments for authorized benefits directly to Cochlear for equipment Cochlear furnished to her. ******************** also provided signed acknowledgements on two occasions that she understood Cochlear was an out-of-network provider with her health plan.Cochlears Reimbursement and ********* team requested and were provided written authorization from ******************** to ship her ***** and to submit the claim for her ***** to her insurance plan. In total, ******************** provided authorized signatures on four separate forms that outlined the details related to her insurance *****.
  
  ******************** chose to place her Baha 6 *** ***** directly with Cochlear using Cochlears Reimbursement and ********* Services instead of with **********************************,who supplied her device and handled the direct billing of her device to her health plan in 2018. When ******************** obtained her Baha 6 *** directly from Cochlear, she assigned Cochlears Reimbursement and ********* Services with the direct insurance billing for her *****. Accordingly, as the durable medical equipment provider, Cochlear was authorized by ******************** to submit the claim directly to her insurance provider.
  
  Cochlear attempted to call ******************** twice after receiving her correspondence through the BBB,and the phone number on file rings without answer or voicemail. Cochlear emailed ******************** with direct contact information to set a time to speak with her about her request for new information to be added to the claim correspondence.  Cochlear remains ready and willing to support ******************** with any further questions or concerns and would welcome the opportunity to discuss.

  Customer response

  04/17/2023

   
  Complaint: 19635401
  
  I am "rejecting" this response because it seems to be a repeat of the misinformation posted before and I wanted to state the resolution accurately, for the record.

  A Cochlear representative, **********, phoned me and listened the details of my situation, including what information I did and did not receive prior to my ordering the BAHA6 device. She then explained why in this case the solution my health insurer suggested would not work. She then proposed a new solution that I am quite satisfied with. I greatly appreciate Ms. ******* reaching out to discuss this with me. 

  I also greatly appreciate the efforts of BBB in helping us reach this satisfactory conclusion.

  I now consider this issue resolved and the case can be closed. 

  Sincerely,
  
  *****************************

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