Contract Type: Hearing Aid (6601)

The contractor and contractor staff that provide services described in this chapter also must comply with Chapters 1–3 of the VR Standards for Providers manual.

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6.1 Overview of Services for Hearing Aids and Related Accessories

The standards in this chapter apply to the purchase in whole or in part of hearing aids and related accessories for Texas Workforce Commission - Vocational Rehabilitation (VR) customers.

VR purchases hearing aids only from contracted manufacturers (contractors).

VR can authorize the purchase of rehabilitation technology, such as hearing aids, related accessories, and other forms of rehabilitation technology, only when it is vocationally necessary and is expected to improve the customer's ability to participate in VR services that are required to obtain, maintain, advance in, or regain employment as defined in the customer's individual plan for employment (IPE).

Contractors must comply with Texas Occupations Code §402.1021, Rules for Hearing Instruments, as applicable.

Upon receipt and acceptance of a service authorization (SA) for the service fees, the hearing aid dispenser agrees to provide the following services at no additional cost to VR or the customer:

  • Initial customer fitting (including activation of a telecoil)
  • Instructions in the care and use of the instrument
  • Up to four follow-up visits for adjustments, including post-fitting evaluation and report of hearing aid performance and customer level of satisfaction

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6.2 Description of Hearing Aids and Accessories

Accessories (for hearing aids) are useful add-ons that can be linked to a hearing aid to assist in hearing more clearly in challenging situations. Examples of accessories include Bluetooth devices and frequency modulation (FM) systems. (VR does not purchase cosmetic accessories.)

Analog hearing aids convert sound waves into electrical signals, which are amplified. Analog hearing aids are customized to meet the needs of each user. The aid is programmed by the manufacturer according to the specifications recommended by a hearing aid dispenser. Analog hearing aids have more than one program or setting and can be adjusted as needed. A hearing aid dispenser can program the aid using a computer, and individuals can change the program for different listening environments (for example, a small, quiet room; a crowded restaurant; and large, open areas, such as a theater or stadium). Analog and/or programmable circuitry can be used in all types of hearing aids.

Behind-the-ear (BTE) hearing aids consist of a hard plastic case worn behind the ear that is connected to a plastic ear mold that fits inside the outer ear. The electronic parts are held in the case behind the ear. Sound travels from the hearing aid through the ear mold and into the ear.

Canal hearing aids fit into the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is made to fit the size and shape of an individual's ear canal. A completely-in-canal (CIC) hearing aid is nearly hidden in the ear canal. Both types are used for mild to moderately severe hearing loss. Because they are small, canal aids can be difficult for an individual to adjust and remove. Additionally, canal aids have less space available for batteries and additional devices, such as a telecoil. Canal hearing aids are not recommended for young children or for individuals with severe to profound hearing loss because their reduced size limits their power and volume.

Contralateral Routing of Signals (CROS) hearing aids treat unilateral hearing loss. The device takes sound from the ear with poorer hearing and transmits the sound to the ear with better hearing. Most systems are wireless and are used either behind the ear or custom built inside the ear. These wireless systems have replaced earlier wired units that were unreliable and bulky. These aids can be incorporated into eyeglasses. Transcranial CROS systems use the conductivity of the skull to transmit sound.

Digital hearing aids convert sound waves into numerical codes, similar to the binary code of a computer, before amplifying them. Because the code includes information about a sound's pitch or loudness, the aid can be specially programmed to amplify some frequencies more than others. Digital circuitry gives the hearing aid dispenser more flexibility in adjusting the aid to a user's needs and to certain listening environments. These aids also can be programmed to focus on sounds coming from a specific direction. Digital circuitry can be used in all types of hearing aids.

In-the-ear (ITE) hearing aids fit completely inside the outer ear and are used for mild to severe hearing loss. The case holding the electronic components is made of hard plastic. ITE aids can have added features installed, such as a telecoil.

Open-fit hearing aids fit completely behind the ear, with only a narrow tube inserted into the ear canal, enabling the canal to remain open. They are often used for individuals who experience a buildup of earwax, since this type of aid is less likely to be damaged by such substances. Some individuals may also prefer the open-fit hearing aid because their perception of their own voice is less distorted.

Post-fitting evaluation is a report of hearing aid performance and customer satisfaction.

Telecoil is a small magnetic coil that allows users to receive sound through the circuitry of the hearing aid, rather than through its microphone. This makes it easier to hear conversations over the telephone. A telecoil also helps individuals hear in facilities that have installed special sound systems called induction loop systems. These systems can be found in many churches, schools, airports, and auditoriums.

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6.3 Returns

Contractors must provide the VR staff member who issued the service authorization (SA) with a written notice of all goods or equipment purchased with VR funds that are subsequently returned to, exchanged, or replaced by the contractor.

This notice must include the following:

  • A description of the item returned
  • The date the item was returned
  • The reason for the return
  • The amount of credit due, if any
  • The customer's name
  • The case identification number
  • A description of subsequent actions that were taken (for example, if the hearing aids were exchanged or replaced).

If the item being returned has a different price or is a substantially different hearing aid or accessory, then VR staff must submit a new SA for the new item.

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6.4 Refunds

When a refund is due, the contractor must remit to VR by the 15th of each month a check in the amount of the total credit accumulated during the previous calendar month. This payment must be accompanied by supporting documentation and/or credit invoices for each transaction or item for which the credit reimbursement is issued. The supporting documentation and/or credit invoices supplied must include the SA number and the customer's VR case identification number.

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6.5 Warranty

Hearing aids purchased with VR funds must have a minimum three-year warranty. Hearing aid accessories purchased with VR funds must have a minimum one-year warranty.

No deductibles may be invoiced for hearing aids or hearing aid accessories.

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6.6 Methodology for Payment

The following established discounts apply to the purchase of all hearing aids and accessories.

Hearing aids and accessories (paid to contractor)

  • Hearing aid: 35 percent discount from the manufacturer’s lowest list price
  • Accessories: 25 percent discount from the manufacturer’s lowest list price

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6.7 Process and Procedure

The contractor provides the hearing aid dispenser with the list price and the VR net price by either supplying a price list or a written quote by letter, fax, or email.

The hearing aid dispenser must submit a completed VR3105D, Hearing Evaluation Report: Hearing Aid Recommendations, with the manufacturer's lowest list price and the cost to VR for the recommended hearing aid and any accessories.

Once approved by the VR counselor, two SAs will be issued: one to the contractor for the purchase of the hearing aid and any accessories and the other to the hearing aid dispenser for related service fees.

The hearing aid dispenser will then submit the SA for the hearing aid(s) and any accessories to the contractor for fulfillment. The contractor ships the hearing aid(s) and any accessories to the hearing aid dispenser for dispensing.

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6.8 Outcomes Required for Payment

For the contractor to receive payment, the contractor must do the following:

  • Provide new (unused) hearing aids and accessories as specified on a SA at the rate established in 6.6 Methodology for Payment (refurbished aids may not be used to meet this requirement)
  • Deliver the products to the specified address on the date and time mutually agreed upon by the VR counselor, customer, and contractor within 10 days of receipt of the SA date or notify the VR staff member listed on the SA of the estimated delivery date upon receipt of the SA
  • Deliver the products in an assembled and fully functional state, including adaptations or fabrication of parts (parts and labor) necessary to meet the described individual needs of the customer
  • Provide a warranty as described in 6.5: Warranty

The contractor must submit an invoice for payment that must comply with the requirements explained in Chapter 3: Basic Standards, and must include the following:

  • The description and quantity of items being invoiced
  • The discounted unit price
  • The SA number
  • The warranty coverage date or warranty expiration date

The date when the customer receives the hearing aid, as noted on the VR3105E, Hearing Aid Fitting and Post-Fitting Report, will be the date used for the 30-day return policy and the receipt date for payment of the invoice from the manufacturer.

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