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Elizabeth M. Whitehorn, Director

Provider Notice issued 02/11/14

Prior Approval for Binaural Hearing Aids

To:​ Audiologists, Durable Medical Equipment and Supplies (DME) Providers, Physicians and Advanced Practice Nurses​
​Date: ​February 11, 2014
​Re: ​Prior Approval for Binaural Hearing Aids

The purpose of this notice is to remind providers of the prior approval requirement for binaural hearing aids in accordance with 89 Ill. Admin. Code 140.497 (d). Binaural hearing aids will only be considered when medical documentation demonstrates that a patient requires more than one hearing aid.

The following information is required when submitting prior approvals to the department for binaural hearing aids:

  • HFS 1409 Prior Approval Request Form (pdf)

  • Medical order

    • Must be signed and dated within the last 12 months by the practitioner ordering the binaural hearing aids

    • Orders written and signed by an Advanced Practice Nurse or Physician Assistant must list their credentials as well as the name of the collaborating physician

  • Testing Information

  • Letter of medical necessity

    • Must be signed and dated by the practitioner ordering the binaural hearing aids

    • Letters written and signed by an Advanced Practice Nurse or Physician Assistant must list their credentials as well as the name of the collaborating physician

  • HFS 3701I Binaural Hearing Aid Questionnaire (pdf)

All prior approval requests and associated information may be faxed to 217-524-0099.

Questions regarding this notice should be directed to the Bureau of Professional and Ancillary Services at 1-877-782-5565, option 5, option 2.

Theresa A. Eagleson, Administrator

Division of Medical Programs