OMS Pre-Surgical Insurance Support

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OMS Pre-Surgical Insurance Support is a division of Cochlear Americas.

OMS contact information - phone: 1-800-633-4667 • fax: 303-524-6765 • www.omsinsurancesupport.com

Otologic Management Services (OMS) is a no-charge service that is available to help patients and providers to obtain necessary insurance coverage and assistance in appealing denied coverage for Cochlear Americas' cochlear implant device and the Baha® system.

What OMS does:

  • Predetermination/Preauthorization assistance (related to surgery and clinical aftercare)
  • Assistance with appeals process, if coverage is denied for surgery and/or clinical aftercare
  • Provide reimbursement guidance and tools to professionals and facilities
  • Advises providers on billing codes appropriate for cochlear implants and Baha procedures
  • Helps with predetermination, authorizations, and appeals involving clinical studies
  • Administers vaccination program

Forms needed for OMS to help you:
(step-by-step procedure below)

The following information is required to enable OMS to provide assistance on behalf of the patient:

Steps to Obtain OMS Services

Please download the forms identified above, have the patient fill them out, and email or fax this information to OMS at Cochlear Americas: (303) 524-6765  - OMS@cochlear.com

  1. Patient Information Form (download PDF)
  2. Send a copy of the front and back of the patient’s health insurance card(s)
  3. Authorization for Release of Health Information Form (download PDF)
    • OMS information is completed in the third box of this form for your convenience
    • You will need to insert your clinic information in the first box and can make copies of this form to utilize for future patients
    • The patient will need to sign and complete the middle box, read the authorization information, sign and date at the bottom of the form
    • Send completed form to OMS
  4. Provide Service Form (download PDF)
    • Please have each patient read this form, and indicate his/her agreement by signing and dating the form where indicated at the bottom
  5. Notice of Privacy Practices
    • Please make copies of Cochlear’s Notice of Privacy Practices (NPP) (download PDF) and give to one to each patient to keep for their records.
    • The patient will acknowledge receipt of the NPP on the Authorization to Provide Services Form referenced in #4 above
  6. Letter of Medical Necessity (signed by physician). Include the following information:
    • Patient diagnosis
    • Course of previous treatment including adverse outcomes
    • Describe the technology recommended and the applicability to this patient’s current situation
    • Identify why these technology benefits are medically appropriate in comparison to a hearing aid
    • Describe the medical rationale for use in this case (safety, quality of life, work-related issues, etc.)
    • Discussion of past trials with hearing aids and related outcomes
    • Changes in patient testing
  7. Audiogram and/or other test results
  8. Copy of insurance denial letter (if applicable)
  9. Copy of insurance benefit book (if coverage denied and booklet is available)

Additionally, you will need to send in these two forms if you haven't filled them out before:

Please download the forms identified above, have the patient fill them out, and email or fax this information to OMS at Cochlear Americas: (303) 524-6765  - OMS@cochlear.com

Other useful links:





Last update: 10/06/10