Advocacy Program Letter
Dear Current and Prospective Let Them Hear Foundation Advocacy Program Clients,
Recently you may have heard rumors that the Let Them Hear Foundation Advocacy Program had stopped accepting appeals where the client had chosen a Cochlear device. This is completely, totally false.
Unfortunately, Cochlear Corporation recently decided to cease providing support to the Foundation’s Advocacy Program. This unilateral decision on their part does not in any way alter our commitment to complete cases which are already in progress at no charge to the patient. However, all funds that the program currently has available have been restricted by their providers to be used for only Advanced Bionics and Med-el appeals. Therefore, the Foundation will find it necessary to charge Cochlear patients wishing to seek our assistance. The price for this work has been set by our board of directors at $1850 for the first 20 hours of work.
OMS, a division of Cochlear Corporation, is advertising that they will now undertake appeals for free. It is the position of the Foundation that any such representation will be viewed by outside objective parties such as external reviewers, insurance commissioners, and judges to be inherently biased since Cochlear has a significant financial advantage in the outcome of the case. In the end, it is you, the patient, who has the final say regarding who represents you in any type of insurance or legal proceeding.
Furthermore, the Foundation’s track record in achieving victory in these cases not only speaks for itself, it SHOUTS. In the past eighteen months, we have completed over 400 cases, each with positive decisions, including:
- twenty-one separate insurance commissioner rulings from eleven different states
- more than thirty different external reviewer rulings from ten different organizations
- almost thirty cases involving illegal contract exclusions.
Several of these wins involved appeals which were originally started by OMS and subsequently continued by the Foundation at the request of the patient after OMS either lost or abandoned the case. In each of those instances, the case was resolved in the patient’s favor after the Foundation became involved.
The name of the Let Them Hear Foundation Advocacy Program is now so well-known in the insurance industry that on several occasions, cases have been settled in the patient’s favor immediately after the patient informed the insurer that we had been appointed in their representative. Altogether, the denials that have been overturned represent over $20 million dollars worth of hearing impairment related services delivered to children and adult patients due to the efforts of the Advocacy Program team. Additionally, over 125 million Americans previously without coverage for single sided or bilateral cochlear implantation now have automatic coverage under their insurance plans for these services. I know of no other source for patients where this expertise exists and such an impact has been made.
We are honored to continue to work on your behalf or on the behalf of your children. We will continue to do so as long as we are able. I would like to thank those that continue to assist us in funding this remarkable program as we seek to permanently change the world of access to cochlear implants for the hearing impaired. We look forward to the day where our funding needs are more permanently resolved so we can get back to full speed.
Sincerely,
Dr. Joseph Roberson
Founder and President
Let Them Hear Foundation
July 31st, 2007
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