Authorization (DDA Clients)

What is a social services authorization?

 A social services authorization is administration approval for certain services, equipment, or supplies before the services are provided to clients as a precondition for provider payment.

How do I request a social services authorization? 

The client or the client’s representative initiates the request for a social services authorization. The provider can assist the client or representative in requesting a social services authorization by providing the following information: 

•  What equipment is necessary. 
•  An estimate of the total cost of all equipment requested. 
•  How the hearing hardware will assist the client to perceive, control, or communicate with the environment in which they live or to increase their abilities to perform activities of daily living. 
•  How the ancillary supplies or equipment will support proper functioning and continued use of the equipment, if the needed equipment supports the continued functioning of equipment the client already uses.

How do I view a social services authorization? 

The social services authorization can be viewed in ProviderOne. If you have questions about the social services authorization, contact the case manager listed on the authorization. 

What happens after the social services authorization is approved?

When the social services authorization is approved, the case manager will authorize using a blanket code SA893. The authorization will be for one unit at the estimated total cost. The provider will then submit the claim using the detailed procedure codes.

Payment (DDA Clients)

What is included in the administration’s payment for hearing aids?

The administration’s payment for purchased hearing aids includes all the following: 

• A prefitting evaluation 
• An ear mold 
• A minimum of three post-fitting consultations

The administration denies payment for hearing aids and services when claims are submitted without the social services authorization number when required or the appropriate diagnosis or procedure code.

The administration does not pay for hearing aid charges paid by insurance or other payer source

Note: To receive payment, the provider must keep documentation in the client's medical file to support the medical necessity for the specific make and model of the hearing aid ordered for the client. This documentation must include the record of the audiology testing providing evidence that the client's hearing loss meets the eligibility criteria for a hearing aid.