Your SummaCare Referral

As an Amplifon certified provider, you are also a SummaCare authorized in-network provider and here's what you need to know for this SummaCare referral:

The HOMELINK Hearing Aid Program for SummaCare Medicare Advantage members is a new funded benefit plan configuration from Amplifon. As of January 1, 2018, all hearing aid claims for SummaCare Medicare Advantage members must be processed under the HOMELINK program powered by Amplifon. You will follow the standard process in www.myamplifonusa.com with the additional requirement of the SummaCare disclaimer form.

Pre-Fitting information:

1. Patient is referred to clinic and appointment is scheduled
2. Amplifon verifies insurance benefits
3. Provider informs patient of the copay of $795
4. Products available at the $795 copay are those products listed in the $795 product tier regardless of manufacturer. SummaCare patients can purchase a higher priced hearing aid(s) on the list, however, their copay remains $795 and the difference becomes the upgrade amount. For example:
   
   

           A. Copay                                $   795

           B. Upgrade Amount             $1,000 ( $1,795 total cost of one device - $795 copay)

           C. Patient Responsibility      $1,795 (A + B = C) ($795 + $1,000 = $1,795)  
    

5. General Upgrade Form is provided by Amplifon and must be reviewed with SummaCare patient prior to fitting.
6. Provider recommends hearing aid(s) and orders from the manufacturer using the appropriate Amplifon bill-to number and your ship-to address. Please reference the PO reference number located on the Receipt of Delivery form. Amplifon pays the manufacturer for hearing aids and earmolds under this plan.

Fitting and Payment:

1. Hearing aid(s) must be fit by a contracted SummaCare professional.
2. Patient pays full invoice amount. Payment to Amplifon may be made via e-check or credit card through www.myamplifonusa.com, or through Care Credit and must be forwarded to Amplifon. If patient cannot pay by e-check, credit card, or Care Credit, then payment by check will be accepted. Checks should be made payable to Amplifon Hearing Health Care.
3. Please send the signed Receipt of Delivery and Disclosure forms along with the Packing Slip from the manufacturer to Amplifon Hearing Health Care within 24 hours of fitting.

• 2 year free supply of batteries with every purchase.
• The first year supply of batteries will be mailed to the customer’s home, along with a reminder letter to contact Amplifon for their second year of free batteries.
• After their two year supply is depleted, the customer may contact Amplifon to find out if additional battery coverage is available.

• Amplifon must have a completed W-9 from you in order to process your dispensing fee. This can be found on our For Providers page of our website.
• You will be paid 60 days after the delivery date. Standard dispensing fees apply.

If you have any questions regarding our new partnership with HOMELINK serving SummaCare Medicare Advantage members in your area, don’t hesitate to call Amplifon at 1-800-920-4327.