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Resources and FAQ
At A&HAA we want to ensure that you have access to all the information you need to make the choices that work best for you. Here we answer some of our most frequently asked questions and provide tips on how to deal with hearing loss, take care of your hearing aid, change your battery, and more. You can also check back to find the most recent news stories about advancements in audiology technologies.
Care Tips
Cleaning your hearing aid
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Use a soft cloth to wipe off visible dirt and oils. Use a stiff toothbrush or the brush you received with your hearing aid to brush the microphones and any visible ear wax at the opening.

Watch the videos below for helpful details on how to clean your specific hearing aid.
How to clean your custom hearing aid (video)
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How to clean the receiver in your hearing aid (video)
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How to clean your BTE hearing aid (video)
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Changing your battery
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Remove the sticker from your battery and let it rest 1-2 minutes before inserting it in your hearing aid. It takes a couple of minutes for the oxygen to activate the zinc in the hearing aid battery to fully power up.

http://www.rayovac.com/products/hearing-aid-batteries/educate/battery-facts.aspx

Watch the videos below for detailed instructions on how to insert the battery in your hearing aid.
Changing the battery on your ReSound LiNX (video)
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Changing your filters
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Many hearing aids have filters that help to keep out ear wax. Even a small amount of wax can block the sound from transmitting to your ear. Use the brush or wire loop tool provided at your fitting clean the filter. In some cases, however, the filter should just be replaced.

Watch the videos below for information on how to change the two most common kind of filters.
How to change a Cerustop filter (video)
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How to change a Resound HF3 filter (video)
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Tinnitus Information
What is tinnitus?
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Tinnitus is one of the most common health conditions in the world and is estimated to affect about 50 million Americans. It is essentially a sound that only you experience, but it may present in a variety of different ways, including ringing, hissing, clicking, buzzing, whistling, humming, pulsing, music, pounding, and more. It may feel like it is in one ear or both, or in the center of the head. Regardless of its severity, it can interfere with your concentration and your ability to hear.

Tinnitus may not cause hearing loss, but it does affect your overall quality of life, as it is associated with a number of other problems such as fatigue, sleep difficulties, stress, trouble relaxing, difficulties concentrating, depression, and irritability.
What to do if everyday sounds are too loud
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This symptom is often related to tinnitus, but there are several effective ways to manage it. The most important thing to remember is to not avoid sounds altogether. If you do, your ears may adjust to the silence and make the problem worse.

- Keep yourself surrounded with sound you find comfortable
Keeping yourself surrounded with comfortable sounds allows your ears to readjust to everyday noises. You can do this by listening to TV or the radio, playing recordings of nature sounds, and other similar activities.

- Listen to sounds you enjoy
If there are certain types of sounds that bother you, listening to sounds you enjoy as often as you can may help you build up a tolerance to those you don’t.

- Only wear hearing protection if absolutely necessary
Again, this is to prevent you from avoiding sound. Only use ear protection when sounds are dangerously or uncomfortably loud (around power tools, at loud concerts, etc.), and remove it as soon as you can once the sound level is safe.
Ways to manage tinnitus
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The most successful ways of managing tinnitus depend on a comprehensive discussion between you and your audiologist. There are many different management approaches for tinnitus, but their success varies depending on the person. We have outlined a number of them below.

- Hearing Aids
Hearing aids often reduce and sometimes eliminate tinnitus, especially with people that experience hearing loss in conjunction with tinnitus. They allow you to hear environmental sounds, which allows the brain to and focus on sounds other than the ones generated by the tinnitus, while also enhancing your communication abilities. They may also reduce stress as listening becomes easier. Some hearing aids have the option to generate additional sounds, such as white noise, which may provide tinnitus relief.

- Progressive Tinnitus Management
Progressive Tinnitus Management (PTM) is a tinnitus management education and support program designed to meet specific individuals’ needs. It is an evidence-based approach developed by the National Center for Rehabilitative Auditory Research (NCRAR) of the Administration of Veterans Affairs in Portland, Oregon. PTM combines benefits from a variety of other methods including: Tinnitus Retraining Therapy, Sound Therapy, appropriate amplification, group or individual educational sessions, cognitive behavioral therapy, guided self management and individualized treatment plans.

- Habituation and Tinnitus Retraining Therapy
Tinnitus Retraining Therapy (TRT) is a method developed by Dr. Pawel Jastreboff at Emory University whose goal is to reduce the perception of tinnitus by using other sounds that make the tinnitus less noticeable. Over time these other sounds are taken away as a person adjusts to the sound of their tinnitus. TRT therapy typically lasts 18-24 months to gain the maximum benefit.

- Cognitive Behavioral Therapy
This counseling approach teaches you to identify how you react to the tinnitus and then learn new responses, thereby reducing the associated negative thoughts and reactions.

- Stress Management
Tinnitus often causes stress and stress has been clinically proven to cause or make tinnitus worse. The key to successful stress management is to find the best method that fits your needs and lifestyle. Biofeedback assisted relaxation can help a person learn to control breathing, muscle tension, and heart rate. Other successful techniques include Yoga, exercise, breathing techniques, hypnosis, and meditation.

- Sound Therapy
Sound therapy has been successful in reducing the effects of tinnitus. It is provided by commercially available programs, such as Neuromonics, as well as non-commercial sound therapy.
Elements that can make tinnitus worse
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- Loud Noise
Loud noise can not only make tinnitus worse, but cause permanent damage to hearing. Ask your audiologist about the various options for noise protection.

- Stress
Tinnitus often causes stress and stress has been clinically proven to cause or make tinnitus worse.

- Sleeping Poorly
Sleeping poorly may cause or make the tinnitus worse. See a medical professional to address troubles with sleeping and any underlying causes.

- Vitamin Deficiencies
Having a deficiency of the daily recommended amount of certain vitamins (like vitamin D, E, B12, magnesium and more) may make tinnitus worse. Your primary care doctor should be able to let you know if you have low levels of these nutrients.

- Caffeine
Caffeine increases stress on the body and in large quantities is thought to make tinnitus worse. If you have sleeplessness related to tinnitus, avoid caffeine for 4-6 hours before bedtime

- Excessive Alcohol
Consuming alcohol in large quantities (more than 7-8 servings a week) makes existing tinnitus worse.

- Ototoxic Medications
Many ototoxic (ear damaging) medications can cause tinnitus and/or make existing tinnitus worse. In some cases, such as aspirin, the effects are reversible when a person stops using the drug. In other cases the damage is permanent, so be sure to discuss your medications with your audiologist.

- Nicotine
Nicotine can increase tinnitus, and is thought to cause tinnitus in some cases. It may also add to sleeplessness.

- Dehydration
One symptom of dehydration may be tinnitus. By drinking 6-8 glasses of water a day, dehydration can be avoided.

- Recreational Drugs
Many recreational drugs have been shown to make tinnitus worse, and in many cases may be the original cause.
Tinnitus resources
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American Tinnitus Association provides videos, FAQs, treatment/management information, local support groups, and research dedicated to tinnitus: www.ata.org

American Academy of Audiology is audiology’s largest professional organization. If you type “tinnitus” into the search field, you will find multiple articles and resources: www.audiology.org

American Speech and Hearing Association is the professional website for Audiology and Speech Language Pathology. Their website has an FAQ section as well as one regarding tinnitus management: www.asha.org/public/hearing/tinnitus/

National Institute on Deafness and Other Communication Disorders (NIDCD) provides basic information about tinnitus as well as other topics related to hearing loss: www.nidcd.nih.gov/health/hearing/noiseinear.asp

PubMed contains literature from a variety of journals. It is a great place to get objective articles regarding tinnitus research. Although you may have to pay to get access to a full article, the abstracts are generally available for free: www.pubmed.gov Our recommended search words/phrases include: Tinnitus, Tinnitus treatments, and Tinnitus hearing loss.
FAQ
What is an Audiologist?
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An audiologist is the professional responsible for the identification of impairments and dysfunction of the auditory, balance, and other related systems. Their unique education and training provides them with the skills to assess and diagnose dysfunction in hearing, auditory function, balance, and related disorders.
- The American Speech and Hearing Association
What are the types and degrees of hearing loss?
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There are three basic types of hearing loss: conductive, sensorineural, and mixed.

- Conductive hearing loss is when sounds cannot pass easily through the outer ear canal to the eardrum. It makes sounds softer and less easy to hear, but can often be treated.

- Sensorineural hearing loss is when there is damage to the inner ear or the nerves that connect it to the brain. Most of the time, it cannot be medically or surgically corrected.

- Mixed hearing loss is a mixture of conductive and sensorineural hearing loss, e.g. there may be damage to both the outer and middle ear as well as the inner ear and nerves.

Degree of hearing loss refers to how severe that loss is and is generally measured in the hearing loss range in decibels (dB HL). “Normal” hearing loss ranges from -10 to 15 dB HL, while “Profound” hearing loss is anything over 91 dB HL.

You can find additional information at the American Speech-Language-Hearing Association: http://www.asha.org/aud/pei/
What are the differences in types of hearing aids?
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- Behind the ear (BTE)
In these hearing aids, the device sits behind the ear lobe. A custom earpiece may or may not be attached to help guide the sound into the ear canal.

- Receiver in the ear (RITE)
In these devices, the receiver sits inside the ear. Customized versions can range from very small to filling the ear. There are a few different types of RITE devices, check with your audiologist to find which one is right for you.

- Custom in the ear devices (ITE): All components of the hearing aid fit in the ear canal. The devices range in size from very small (solely in the ear canal) to filling the bowl of the ear, allowing for easier insertion.
              - IIC-Invisible in the canal
              - CIC-Completely in the Canal
              - ITC: In the Canal
              - ITE: In The Ear

- Implantable Hearing Technology
Implantable hearing technology may be appropriate for specific types of hearing loss. They require surgical implantation of at least a portion of the device.

              - Osseointegrated hearing devices
These are bone-anchored hearing devices that provide another treatment option for people with conductive or mixed hearing loss. A small titanium vibrator is inserted behind the ear. Sounds cause it to vibrate, and its vibrations are transmitted to the inner ear via the bone to produce the sensation of sound. Consult your audiologist to see if this treatment is right for you.

              - Cochlear Implants
These are small electronic devices that help provide a sense of sound. They consist of an external portion that sits behind the ear and another portion that is surgically placed under the skin. The implant contains a microphone, a speech processor that selects and arranges the sound picked up by the microphone, a transmitter/receiver that receives signals from the processor and turns them into electrical impulses, and an electrode array that sends the impulses to different regions of the auditory nerve.
Hearing Aid News and Tidbits
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Hidden Risks of Hearing Loss
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Recent article from John Hopkins discuss the Hidden Risks associated with hearing loss.
Risks include withdrawal, social isolation and changes in the brain. Other risks include increase risk of falling and cognitive decline.

Schedule an appointment today if you have concerns about hearing loss or balance issues. Audiology and Hearing Aid Associates in La Grande, Oregon can help you better understand your risks and work with you to create a management plan that works for you.
How We Hear
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We hear with our brain. Our ears gather sounds and convert them into a signal that the brain can understand. Our brain then processes this information to provide us with these sounds’ meaning.

Hearing loss can be caused by blockage or damage to any part of the ear, including up to the brain’s auditory cortex. Seeing an audiologist can help you diagnose which part of your ear is affected and develop a treatment plan for your specific type of hearing loss. Check out our Resources section for more information on hearing, hearing loss and treatment/management options.

This short video provides a great overview of how our ears work.
How do I pay for hearing aids?
Overview
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At A&HAA we know it can sometimes be confusing to figure out the best way for you, specifically, to pay for your hearing aid. The first thing to understand is that the hearing aid device is only a part of the complete package that will lead toward better hearing. In fact, the specialized programming and follow-up services we offer are more important than the actual hearing aid itself so please make sure you understand what your service package entails.

Below are funding and financing resources for hearing aids and services, organized into the following categories: Financing, Health Insurance, Discount Plans, Income Based Grants/Charitable Care, Government Programs.
Financing
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Take advantage of these options to plan ahead when determining how to pay for your hearing aids:

- HSA or FSA
Health Saving Accounts or Flexible Spending Accounts can be used to put aside pre-tax dollars for qualifying medical expenses. Hearing aids, hearing aid supplies and hearing aid batteries are all IRS-Qualified medical expenses.

- Health Care Line of Credit
Many private banks offer lines of credit for healthcare related expenses at special rates. Make sure you understand the fees associated with any credit line you are pursuing.

Northwest Access Fund <links https://nwaccessfund.org> offers low interest loans for people with disabilities and for seniors. Hearing aids are an eligible expense.
Health Insurance
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Understanding your hearing aid benefits can be pretty challenging, since some insurances include a paid hearing aid benefit, while others have partnered with third parties to secure discounts for their subscribers. For instance, did you know that Oregon requires insurance companies to cover hearing aids for children? Below, we explain some of the frequently used and confused terminology in the world of insurance benefits.

- EOB
Explanation of Benefits. Insurance companies often send this in paper form following an insurance claim. It explains what the insurance paid and what they were able to obtain as a contractual off the charges (adjustments off the original charges that the health care facility extends to that plan’s subscribers based on contracted discounts).

- Deductible
Some insurances require that you meet your deductible before you can access portions of your health care benefits. Some plans separate hearing aid coverage from the deductible.

- Max allowable
This is typically the maximum dollar amount that the insurance will pay toward a certain benefit. In some cases you might be responsible for any portion of the charges not covered by the insurance. Sometimes, the insurance has negotiated with the facility that there is a maximum charge or a cap on how much the hearing aids can cost. Sometimes this may create limitations on available technology under your specific benefit.

- Max out of pocket
Once you have met your maximum out of pocket, the insurance is obligated to pay 100% of all remaining covered charges. Hearing aids, however, are often excluded from the max out of pocket coverage.

- Co-Pay/Co-insurance
Insurance companies will often share expenses with their subscribers to help keep deductibles down. The co-pay or co-insurance is the subscribers’ portion of the charges.
Discount Plans
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Discount plans are often third party companies that operate as the middleman between the insurance companies, the audiologists, and the consumer. Companies (Hearing Planet, Epic, TRUHearing, HearPO and others) purchase hearing aids in large quantity from the manufacturer. The costs of professional services, fitting and follow-up care are often left out. The follow up care and fitting services are then purchased a la carte.

In the end, most patients find they have spent as much or even more for hearing aids and services by going through these types of plans than they would if they had gone through their local audiologist and obtained a comprehensive hearing treatment plan.

Many audiology clinics offer discounts such as trade-in offers, refurbished hearing aids at a reduced price or new technology promotions. Ask your local audiologist for information on available offers, make sure you understand what the offer covers as it might be limited to specific technology.
Government Programs
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- Veteran’s Administration
It determines eligibility and availability of services. If you think you may be eligible for benefits, contact your local VA office: http://benefits.va.gov/benefits/

- Medicaid
A state and federally funded insurance plan that is required by federal law to provide hearing aid coverage for children. Coverage for adults varies by state. Here is Oregon’s: https://www.healthinsurance.org/oregon-medicaid/

- Vocational Rehabilitation
Hearing loss can be a barrier to steady income, and VR helps to alleviate that barrier. For children in 11th grade and up, VR can be a tool to assist in ensuring needed supplies (i.e. books) for college and support in class are available to the student through self-advocacy and assistive aids such as transcription services. This program is funded through the Federal and State governments to assist those with disabilities obtain or maintain their employment by providing job retraining, financial assistance or resources needed to perform job duties. This requires a meeting with a Vocational Rehabilitation counselor to review needs and establish a plan of care. http://www.oregon.gov/dhs/employment/VR/Pages/index.aspx
Income Based/Charitable Care
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If you are having trouble paying for your hearing aid and care through the above resources, there are several organizations and groups that offer grants, scholarships, sliding fee scales and charitable care for hearing aids. Some are age-based, some are income based. Some are regional or local and some are national.

- AG Bell
Alexander Graham Bell Association for the Deaf and Hard of Hearing has several financial grants for different ages and levels of hearing loss. Some examples of grants include: Parent and Infant Financial Aid Program, Preschool Age Financial Aid Program, College Scholarship Program. Please see their website for detailed information about the grants and when to apply. https://www.agbell.org/financial-aid/overview/

- Help America Hear
A program by the Foundation for Sight and Sound, this is considered a last resort grant that can be applied for once every 5 years. There are income and hearing loss requirements that need to be met. There is also a non-refundable application fee to begin the application process. https://foundationforsightandsound.org/help_america_hear_program1.php

- Hear Now
Supported by the Starkey Hearing Foundation, the application process requires a non-refundable processing fee per ear. If the application is accepted, hearing aids can be provided to the patient. Hear Now partners with local audiologists who donate their services and time to provide the fitting. Follow-up care is billable and is to be paid upon service received. https://www.starkeyhearingfoundation.org/Hear-Now

- Lion’s Club-Oregon
Provides financial assistance to individuals based on income and availability of funds. Application; complete and return to the Foundation office, ensuring the checklist and documentation requested on their website is included:
http://www.olshf.org/
http://www.lagrangelionsoh.org/hearing-aids.html

- Travelers Protective Association
Based out of Missouri and established in 1975, the Scholarship Trust for the Hearing Impaired provides financial aid to people with deafness or hearing impairment. On their website, www.tpahq.org, choose ‘scholarship trust,’ and follow the link for the application. The amount of the award is based on need and is decided upon by the Trustees of the program. https://www.tpahq.org/scholarshiptrust/apply/

- United Healthcare Foundation
Even with private insurance, you can apply for this medical grant up to $5,000 based on financial need for children ages 16 years and younger. There is an online-only application process. Caution: This grant can take several months to be awarded. http://www.uhccf.org/

- Scholarships
There are a number of scholarships available to help hearing-impaired students. This website contains a list of resources, grants and financial aid: https://del.icio.us/hlpuears/Scholarship

- Caption Call
If you can provide a professional certification form certifying your hearing loss, CaptionCall will install a phone with a large screen that displays written captions of what callers are saying for free. https://captioncall.com/ You can also go to their blog for information on hearing loss and healthy aging: https://captioncall.com/ccblog/
Support Resources and Links
Hands and Voices
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http://www.handsandvoices.org
Hands & Voices is a non-profit, parent-driven organization dedicated to supporting families of children who are deaf or hard of hearing. We are non-biased about communication methodologies and believe that families can make the best choices for their child if they have access to good information and support.
Forms and Privacy
HIPAA Privacy Statement
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Your Information. Your Rights. Our Responsibilities.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Your Rights
You have the right to:
• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated
Your Choices
You have some choices in the way that we use and share information as we:
• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
• Raise funds
Our Uses and Disclosures
We may use and share your information as we:
• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.



Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes
In the case of fundraising:
• We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treat you
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.

Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety
Do research
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

© 2018 A&HAA, All Rights Reserved
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