By Nicole Craig, Senior Manager of Managed Care and Market Access, Cochlear Americas
Otologic Management Services (OMS) request forms have been updated to include the launch of the new Osia® System. Use of these forms will allow providers to submit requests for any product, as well as streamline compliant communication between parties.
A division of Cochlear Americas, OMS is a dedicated team of reimbursement specialists who are available at no cost to help clinicians and their patients obtain the necessary pre-surgical insurance approvals, or support appeals where coverage is denied for Cochlear’s Nucleus®, Baha® and Osia Systems for medically qualified candidates. Updated forms that were issued in February 2020 will no longer be accepted as of October 1, 2020.
The information requested on OMS forms is required by health plans in order to process the request. As OMS submits the information on your behalf, it is very important that the information is complete and legible (typed is strongly preferred) to avoid any delays. The forms are PDF editable, so completing the basic information for each provider and saving as a template for future use is suggested. Whenever possible, OMS prefers to receive documents via email given the clarity is typically better than faxed items; however, OMS can receive documents in both formats to accommodate providers. Requests received with incomplete documents may be delayed while attempting to secure the required information or clarification of the information shared. The team recognizes the value of your time and the importance of quick turnaround times for both you and your patients; therefore, we would like to share the required paperwork and documents needed to process requests. Here are the documents required for each case when submitting a request to OMS:
- Surgical Procedure Authorization Request Form with supporting documentation:
- Copy of the patient’s health insurance card
- Letter of medical necessity (templates available upon request)
- Current chart notes, CT results & hearing test results including audiogram
- Patient Authorization to Provide Insurance Support Services Form (Patient signature required)
- Authorization for Release of Patient Health Information Form (Patient signature required)
- Notice of Privacy Practice should be distributed to patients, but no signature required
To obtain the updated forms or learn more about working with OMS, visit our website, contact via email at OMS@Cochlear.com or watch these webinars.
About the author:
Nicole Craig is the Senior Manager of Managed Care and Market Access for Cochlear Americas. She oversees OMS and managed care contracting for Cochlear’s external DME replacement parts and accessories.
Information provided by Cochlear Americas regarding insurance coverage or reimbursement is provided as guidance only and is not intended as reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding such information or its completeness, accuracy, fitness for a particular purpose, or that following such guidance will result in any form of coverage or reimbursement from any insurer. Information presented is subject to change at any time. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own experts and seek your own legal advice regarding your reimbursement needs. In all cases, products or services billed must be medically necessary, actually performed and appropriately documented in the medical record.