May 30, 2025 • 28 mins
Achieving a hearing aid return rate below 1% isn't accidental—it's the result of thoughtful systems and genuine patient care. Drawing from years of successful private practice experience, this episode unpacks strategies that transform patient outcomes while strengthening your practice's financial health.
Financial barriers represent a significant obstacle for many potential hearing aid users. By implementing flexible financing options tailored to patient needs, you remove a major reason for hearing aid returns while expanding access to hearing technology. But addressing affordability is just the beginning...the consultation process itself determines much of your success. Through motivational interviewing techniques that replace closed-ended clinical questions with deeper explorations of patient goals, you create the foundation for successful fittings.
The patient experience extends far beyond the initial fitting. We explore how comprehensive onboarding systems—complete with educational materials, structured follow-up schedules, and even customized resources like podcast episodes that address common questions—transform the hearing care journey from a transaction into a relationship. When patients feel part of a supportive program rather than simply purchasing a product, they become invested in their success and less likely to return their technology.
Audiological best practices aren't just clinically responsible; they directly impact satisfaction rates by ensuring optimal performance. By setting realistic expectations about adaptation periods and guiding patients through what to expect, you establish appropriate benchmarks for success. Perhaps most importantly, recommending appropriate technology based on comprehensive assessment—not assumptions about what patients will spend—ensures they receive maximum benefit from their investment.
Ready to transform your practice's approach to patient care and reduce your return rate? These strategies will not only improve your performance metrics but fulfill our deeper mission: ensuring more people with hearing loss receive the treatment they need to live fuller, more connected lives.
Connect with the Hearing Matters Podcast Team
Email: hearingmatterspodcast@gmail.com
Instagram: @hearing_matters_podcast
Twitter: @hearing_mattas
Facebook: Hearing Matters Podcast
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Blaise M. Delfino, M.S. - (00:19):
Thank you you to our partners.
Sycle (00:21):
built for the entire hearing care practice.
Redux (00:25):
the best dryer, hands down.
CaptionC all by Sorenson (00:29):
Life is Calling.
CareCredit (00:32):
Here today to help more people hear tomorrow.
Fader Plugs (00:36):
the world's first custom adjustable earplug.
Welcome back to another episodeof the Hearing Matters podcast.
I'm founder and host, blaiseDelfino, and, as a friendly
reminder, this podcast isseparate from my work at Starkey
.
I'm your host, blaise Delfino,and I hope you're all having a
(01:00):
wonderful week.
If you're listening to this, itmight be morning, afternoon,
evening.
Either way, thank you forlending your ears and thank you
for joining us on our mission toraise awareness of the
importance of hearing healthcare.
And whether you're a studentstudying speech pathology or
audiology, you're a privatepractice owner, ent, or even a
(01:22):
current or future hearing aiduser, we welcome you with open
arms and we hope that thisplatform assists you in making
an educated decision regardinghearing health care.
I've been reflecting a lot,especially when I was practicing
full-time as a private practiceowner and hearing instrument
specialist, and every December31st, especially before the new
(01:45):
year, I would look at our keyperformance indicators, most
commonly referred to as KPIs,and I would always look at
specific numbers, but, mostimportantly, our return for
credit rate or RFC, and one ofthe reasons I looked at that was
not because to say, oh you know, only 10 patients this year
(02:08):
returned their hearing aids.
That's great To me when apatient would return their
hearing aids.
I took that very personallybecause I love what we do.
As hearing care providers wereto return their hearing aids, I
felt as though I had failed them, especially if they had a
severe hearing loss, and Ipersonally learned not to take
(02:29):
it personally.
We always walk through.
But I will say full disclaimerhere.
Our return rate was less than1% and I don't share that to
brag or boast or to impress you,but rather impress upon you
that I do know what it feelslike when a patient returns
their hearing aids.
Some are not ready, some it istruly a financial aspect, but we
(02:52):
learned quickly to reframe howwe were speaking with our
patients, our service deliverymodel, our patient experience,
and that's why we have and hadsuch a low return rate.
So again, that number, I lookedat that and if we had a low RFC
, what that told me is we havehappy patients that are telling
(03:12):
their friends about their newhearing journey and that's also
showing that our team is allwalking in lockstep.
We're all walking together inthe same direction, helping
patients hear life's story, andI really felt it in my heart of
hearts to talk to you today anddiscuss ways in which you can
reduce hearing aid returns.
(03:34):
Now we are this band of hearingcare providers that truly are on
a mission to raise awareness ofthe importance of hearing
health care, and we have a lotof work to do.
We need to continue to removethe stigma and oftentimes new
hearing aid users, when theycome into the clinic, they might
be a little skeptical and theyare going through that grieving
(03:55):
process and, I can assure you,embodying empathy.
So, ways in which we canimprove our return for credit
rate.
Now, again, we want to have alow RFC rate, a low return for
credit rate.
If we have 50% of our patientsreturning their hearing
instruments, the problem isprobably the individual looking
(04:18):
at you in the mirror.
We don't want 50, 60, 70%because, again, it's also not in
the best interest of thepatient.
Don't want 50, 60, 70 percentbecause, again, it's also not in
the best interest of thepatient.
But I know that you listening,right now you have a low RFC
rate.
So, number one, how to improveour return for credit rate.
Are you, and is your clinic,offering appropriate financing
(04:39):
options?
Now, today, access is a buzzwordin the hearing health care
space.
We talk about access totechnology, access to hearing
healthcare, and we do have manyplatforms that do provide access
to hearing healthcare andhearing care providers.
But are you, the hearing careprovider, offering appropriate
financing options to yourpatients?
(05:01):
There was a study that wasconducted and these findings
were released on January 2nd2023.
And it writes Americans arefalling short on the savings
front.
According to the State ofPersonal Finance in America 2022
, a study conducted by RamseySolutions, there's a clear
shortfall in personal savingsamong millions of Americans.
(05:24):
The study revealed that 36% ofall Americans have absolutely no
savings at all, and another 19%have less than $1,000 saved.
Just 45% of all Americans have$1,000 or more in savings.
Now, the reason I bring that upas hearing care providers, we
(05:47):
also have to embody financialliteracy, especially if you are
running a private practice,because numbers really do tell a
story.
But one way to reduce yourreturn for credit rate is to
offer these appropriatefinancing options, because what
that study just showed us isthat there are going to be
patients that come to us that donot have liquid funds to pay
(06:13):
for their hearing technology.
So we need to ensure that weare sensitive to that.
We know, as hearing careproviders, that the cost of
untreated hearing loss isgreater than the price of the
hearing technology, but we alsohave to be understanding and
aware that not every patient,even if they that the cost of
untreated hearing loss isgreater than the price of the
hearing technology, but we alsohave to be understanding and
aware that not every patient,even if they need that premium
technology, will be able toafford that.
(06:33):
So I challenge you to audityourself, audit your practice.
What financing options areavailable to my patients?
Am I working with anorganization like a care credit?
What are the terms?
I understand as a hearinghealthcare practice?
It costs you to offer financingoptions.
(06:55):
But again, that is one of thosecosts of doing business and
reflecting with you and yourteam who set those price points,
ensuring that it is not onlyfair to your practice but also
the patient in terms of whatfinancing options are available,
whether it be that 12-monthterm, 18-month term or 36-month
(07:16):
term.
So what is going to help thepractice, what is going to help
the patient and what is going tobe that appropriate middle
ground.
The second way to improve yourreturn for credit rate is
implementing motivationalinterviewing.
Are we asking the rightquestions?
I always loved implementingmotivational interviewing
(07:40):
because number one, you reallyget to know the patient much
deeper than just asking do youhave ear pain, yes or no?
That's what the patient intakecan answer, all of those yes or
no questions, those close-endedquestions.
With motivational interviewingwe're really getting deep in
terms of those open-endedquestions.
(08:01):
How is this patient feeling?
What is their motivation levelto engage with hearing
technology, to even make thedecision today to walk out with
hearing technology?
And when you are implementingmotivational interviewing, this
is usually when you bring thepatient back to the audiology
(08:22):
suite before you test theirhearing.
If the patient brought withthem a family member or a spouse
, or they had a third party withthem, I would always ask the
patient Mrs Smith, what wouldyou like to accomplish today?
And that was always the firstquestion I asked.
And then I would look to thespouse or the third party and I
(08:43):
would ask him or her what wouldyou like to accomplish today?
And after that question, prettymuch nine times out of 10, the
patient would say I've never hada health care provider ask me
what I wanted to accomplish atthe appointment.
And number one you need to begenuinely curious as to why
(09:03):
they're here, what they wouldlike to accomplish today,
because if they walk out of theclinic feeling as though that
they haven't accomplished whatthey came to accomplish, they're
not going to have that sense offulfillment.
So your job as that hearinghealthcare provider is to ensure
you're providing them thatplatform to accomplish what they
wanted to.
Nine times out of 10, especiallyif it were the husbands, it
(09:25):
would say.
I want to prove to my wife thatit's selective hearing and
we've heard that so many timesbut ensuring that you make them
feel comfortable, upfront duringthe motivational interviewing
process and you're asking theright questions.
And that would then follow upby understanding and asking them
(09:46):
what a typical day like is forthem, especially as it relates
to communication.
On a scale of 1 to 10, 1 beingyou're not socially active to 10
you're very socially activewhere would you put yourself
today?
Well, I'd probably put myselfaround a 4 or 5.
Tell me about your socialactivity level 10, 15, 20 years
ago, before you started tosuspect that you presented with
(10:08):
hearing loss, oh, I was at a 10.
So now we understand, we knowwhere to go.
Now there are patients that maybe introverts or ambiverts, but
again, this motivationalinterviewing allows you upfront
to really deep dive andunderstand.
Is the patient motivated to dosomething about their hearing?
Are they here because theirspouse pushed them?
(10:28):
You're still going to give thispatient 110%, but there are
patients who are truly just notready to take that step towards
better hearing.
A third way that you can improveyour return for credit rate is
appropriate onboarding andfollow-up schedule for the
(10:50):
patients just fit with hearingtechnology and patients who have
been wearing hearing aids for10, 15, 20 years.
When we talk about onboardingand follow-up schedule, first
and foremost, when we started inprivate practice full-time, and
especially following graduateschool in 2017, we knew that by
the year 2020, the majority ofconsumers would make their
(11:13):
purchasing decisions based onthe experience that they had,
and we asked ourselves and weaudited ourselves.
Sometimes it's very hard tolook inside the picture or
inside the jar.
What are we doing right now?
That is not the best experiencefor patients.
What can we do startingtomorrow?
What is that low-hanging fruitthat we can start to implement
(11:35):
to create the best patientexperience possible?
And it came down toimplementing an onboarding
schedule and experience that ourpatients absolutely love.
So what does that look like?
When a new patient moves forwardwith hearing technology, we
send them home with a folderthat is branded to our practice
(11:58):
and then inside that folder weincluded information about
today's visit, information aboutthe technology that they're
moving forward with.
We included one of our mostrecent quarterly newsletters so
this patient could go home andread more about the hearing care
provider and hearing carepractice that they're moving
forward with.
(12:18):
And this is really how theHearing Matters podcast came
about.
Because we started this podcastsolely for the patients that we
were fitting in the clinic.
Because if a patient would gohome and have questions, we
wanted to record episodes thatthat patient could go back and
listen to, especially if theywere moving forward with a
specific hearing aidmanufacturer you know we've
(12:40):
talked about the differenthearing aids available or if
they want to understand whatwe're going to accomplish at
their first follow-up, werecorded an episode all about
their first follow-up.
So, coming into that fittingappointment, for example, that
patient knew what we were goingto cover and what it did.
Is it decreased majority of thequestions and I will tell you 80
(13:04):
to 90% of the new patients thatwe fit with technology.
Whether it was the patientlistening to the episode or
their spouse or third partymajority listened to the episode
and it was a lot of fun.
Our patients said, wow, like Ican't wait to listen to next
week's episode.
So what you were doing is youwere creating an experience and
we were creating an experienceand a community and a platform
(13:27):
for our patients to feeleducated, welcomed and there was
no smoke and mirrors, right, asa consumer.
Let's just say you go topurchase a new vehicle and the
dealership doesn't show you howto use any of the buttons in
this car that you know today'svehicles.
They look like spaceships nowinside.
(13:47):
So like what does this buttondo?
What does that feature do?
As hearing healthcareprofessionals, it is our duty
and responsibility to focus onthe benefits of the hearing
technology first and the featuresecond.
But what does that onboardingschedule look like?
So we always, of course,implemented their fitting
appointment first follow-up,second follow-up.
If they felt as though thatthey needed a third follow-up,
(14:10):
of course, we satisfied that,and then, every six months, we
saw them for a clean and check.
So we're seeing our patients atleast following that onboarding
schedule two times a year atleast.
The patients did incrediblywell and again, this absolutely
positively influenced andimpacted our very low return for
(14:34):
credit rate.
I will tell you we implemented asystem.
We created a system.
We created a system and I wasnever afraid of Mrs Smith coming
back to the hearing care clinicwith her manufacturer bag in
hand, not wearing the hearingaids, saying I came to return
these.
What this system and processdid, not only for me as a
(14:57):
hearing care provider, but forour team, is it increased our
confidence.
So if we take a look at this,you know you have a low return
for credit rate.
You're offering appropriatefinancing options, you're
implementing motivationalinterviewing and you have a
system that ensures that thepatient is onboarded properly.
Just these three things alone.
(15:19):
If you implement, you will seea drastic decrease in your
return for credit rate.
The patients felt part of aprogram versus a transaction.
With our onboarding andfollow-up schedule, think about
the last time you felt as thoughyou were truly heard at a store
or a shopping experience.
It could be a healthcareprovider as well.
(15:42):
Did you feel heard?
Did you feel part of a programor did you feel as though it was
just a transaction.
We are human beings and we aresocially connected.
We are social beings.
We want to feel part ofsomething, especially in the
hearing healthcare industry.
There is no industry like ours.
We can never turn our hearingoff, it is always on.
(16:04):
And our patients, when theystart to sense that decrease in
hearing, oftentimes they maystart to experience that loss of
self, and that's where grievingcomes in.
So, if anything, we discussedtoday the ways in which to
decrease your return for creditrate.
This is number one.
This is really, reallyimportant that you create a
(16:27):
system and or refine yourcurrent system to ensure that
the onboarding schedule is firstclass.
We would always follow up too.
When a patient was fit with newhearing technology, we sent them
a thank you card.
It's those little things.
New hearing technology we sentthem a thank you card.
It's those little things.
And that thank you card handsigned, oftentimes handwritten.
Because, if you go back to thebasics, we live in a world of
(16:50):
artificial intelligence and it'sphenomenal technology.
The hearing aids use AI andit's friendly AI, but we, as
hearing healthcare providers andbusiness owners, private
practice owners, cannot losethat human touch.
Blaze, I don't have the time.
I get it.
We all have 24 hours in the day.
However, can you pre-sign someof these thank you cards and
(17:12):
your front office staff fillthem out?
So it's those little thingsYou've never been bitten by an
elephant, but you've been bittenby a mosquito so it's the
little things in business andlife that really come back to
bite us.
The fourth way to improve anddecrease your return for credit
rate is drumroll, please.
Implementation of best practices.
(17:33):
We are not going to deep diveinto this today, because you, as
a hearing health care provider,know you should be conducting
speech and noise testing, videootoscopy, tympanometry,
otoacoustic emissions,functional gain testing, real
ear measurement.
Those are just a few bestpractices that we, as hearing
care providers, should beimplementing.
(17:54):
When you implement bestpractices and one of them,
absolutely a tool that we'veused and continue to use, is the
use of the AFAB, theAbbreviated Profile of Hearing
Aid Benefit how is theimplementation of best practices
, blaze, going to reduce myreturn for credit rate?
Here's how.
When you implement bestpractice, you know that you are
(18:17):
hitting their targets for bestspeech and understanding.
When you do real earmeasurement, when you implement
tympanometry, you know thattheir middle ear space is
functioning appropriately.
You know what their speech andnoise testing scores are.
So what you're going to do isincrease some of that digital
noise reduction.
Reduction the implementation ofbest practices allows you to
(18:39):
fine-tune the hearing technology, but also understand.
What additional communicationmethods do I need to discuss
with this patient to ensure thatthey're hearing to the best of
their ability.
When you do that, the patientis going to be happy.
They're going to feel heard.
They're going to feel part ofthe community with which they
once were able to communicate in, but maybe they've recently
(19:01):
withdrawn, or the past yearshave withdrawn, and what they're
going to do is tell theirfriends and family about their
new hearing world.
And if a friend or familymember of this said patient also
feels as though that theypresent with a hearing loss,
they're most likely going tocall you.
Which again?
A decreased return for creditrate or a low return for credit
(19:22):
rate.
What that also carries overinto is increase in patient
referrals, because your patientsare happier and your practice
is going to continue to help somany community members.
Let's talk about the fifth wayto decrease return for credit
rate.
To decrease return for creditrate, set realistic expectations
.
This is really, reallyimportant to do, and the reason
(19:49):
why is because when you areworking with patients and you're
setting realistic expectations,your patients have this
guidepost of okay.
My hearing care provider told methat the goal of a hearing aid
is not to make everything louder, it's to make speech clearer,
and I am not going to havesupersonic hearing with these
hearing aids.
The hearing care provider alsotold me that there are sounds
(20:11):
that I've heard before that maysound a little louder the first
week or two.
Some sounds may sound harsh,but my brain is going to
acclimate to this new hearingworld.
I really wanted to talk to youtoday about you know when you
set these realistic expectations.
If I were to say, mrs Smith, weneed to set realistic
(20:31):
expectations here, well, thehearing technology today is
incredible and you have theseamazing features like biometrics
and fall detection incredibletechnology.
The goal of the hearing aid isto help you understand speech
clearer, not only in simple butcomplex listening situations
(20:51):
like a restaurant, bar area orjust around family during the
holidays, but also thetelevision.
So we set realistic technologyexpectations.
We set realistic listeningexpectations, and the patients
would always say thank you fordoing that, because we also have
to understand that this patienthas been grieving.
(21:12):
They are looking for somerelief If we shoot for the stars
and we over-promise what thetechnology is going to do for
them.
Number one it's not in the bestinterest of the patient because
when you set unrealisticexpectations, they're going to
get frustrated and guess what?
They're going to return theirhearing aids.
Who cares about the return?
What I care about is thispatient who has been struggling,
(21:35):
maybe for a few years, who isnow not wearing technology, and
we understand the comorbiditieslinked to untreated hearing loss
.
So, as hearing healthcareproviders, it is our duty and
responsibility to set theserealistic expectations.
When you're setting realisticexpectations, oftentimes this
conversation leads into thepatient maybe asking well, how
(21:59):
long do I have to try thehearing aids?
What we did is we replacedtrial period with adjustment
period.
So we would say Mrs Jones, youhave a 30-day adjustment period.
What this allows us to do as ateam is to ensure that you're
satisfied with your new hearingworld.
(22:20):
We're going to make adjustmentsto the hearing technology and
we're going to track yourperformance, not only with the
hearing technology, but from acommunication standpoint as well
.
I would encourage you replacetrial with adjustment period.
Last but not least, the sixthway to decrease your return for
(22:42):
credit rate and improve this KPIis to recommend appropriate
hearing technology.
So when you've implemented bestpractices and the patient has a
92% word recognition score, butthey have a severe speech and
noise score and they have a veryactive lifestyle and they're 65
(23:06):
.
You're most likely going torecommend premium hearing
technology.
However, that's also where thatappropriate financing option
comes into place.
This is where you talk aboutthe price of the technology,
what comes with that, warranty,et cetera, et cetera.
I'm not going to tell you howto run your business from a
warranty standpoint or a pricingstandpoint.
(23:26):
That is between you and yourbusiness only.
But when we are recommendingappropriate hearing technology
and we are leading with highstandard of care, what does that
mean?
What does that high standard ofcare mean?
We need to make the bestrecommendation for the patient.
Oftentimes I've heard of storiesat different conferences and
(23:47):
conventions where providers willsay my patients will not spend
X amount for premium technology,so I always offer mid to lower
tier hearing technology.
I can understand the reasoningbehind that, but I also believe
that you are taking away theopportunity for your patient to
(24:07):
hear even better with premiumtechnology.
So if you recommend, let's justsay okay.
Mrs Smith, we know that youpresent witha significant
hearing loss and you told methat you live a very active
lifestyle.
Your goals are to understand.
In restaurants, in meetings,your husband expressed to us
(24:29):
that he wants you to hear betterwhen you go out to dinner, when
he takes you out to dinner andpicks up that bill.
Right.
Based on your significanthearing loss, your social
activity level and what youwould like to accomplish, I am
going to recommend the premiumhearing solution that we have in
the clinic which costs X, andthen what you do is you stop
(24:52):
talking and implement wait time.
When you do recommendappropriate hearing technology
and your case presentation iseducational, not transactional.
Again, that patient is actuallymaking the decision, as they
should be.
You're that guidepost.
Oftentimes they're going tomove forward with your
recommendation.
If you change the paradigm of Iam providing so much value.
(25:16):
This patient is going to hearso much better.
They're going to communicate somuch value.
This patient is going to hearso much better.
They're going to communicate somuch better.
The goal here as a hearing careprovider is to again educate
them.
We know that they're going tohave their technology for quite
a few years Now.
That's where that appropriatefinancing option comes into play
.
If the patient truthfully cannotafford premium hearing
(25:39):
technology, discuss lower tiertechnology.
But again, you need to thenreset those realistic
expectations.
If you go from a premium tomid-level device, well, you have
a severe speech and noise score.
If we go with the mid-leveldevice, this is what you can
expect.
If you are going into a lowertier technology device, this is
(26:00):
what you can expect If you aregoing into a lower tier
technology.
Please recommend and everyprovider should be doing this
including a remote microphone toincrease that signal to noise
ratio, and that should bewhether it be low, mid or
premium technology.
So again, six ways to improveyour return for credit rate and
reduce your RFC.
Because, again, your return forcredit rate and reduce your RFC
(26:23):
?
Because, again, yes, we want toensure that our practice is
thriving and we're able to helpas many patients as possible.
One of the reasons we want toreduce the return for credit
rate is because there's millionsof individuals out there with
hearing loss.
We want to show up for themevery single day and by doing so
, they are going to be happypatients, they're going to be
(26:44):
champions of better hearing andthey're then joining our mission
to raise awareness of betterhearing.
Thank you again for joining usfor another episode of the
Hearing Matters podcast.
Today we discussed ways inwhich we can reduce hearing aid
returns, not because it's what'sin the best interest of the
practice, but because it is whatis in the best interest of the
(27:07):
patients.
I'm your host, blaise Delfino,and until next time, hear life's
story.
Thank you you to our partners.
Sycle (00:21):
built for the entire hearing care practice.
Redux (00:25):
the best dryer, hands down.
CaptionC all by Sorenson (00:29):
Life is Calling.
CareCredit (00:32):
Here today to help more people hear tomorrow.
Fader Plugs (00:36):
the world's first custom adjustable earplug.
Welcome back to another episodeof the Hearing Matters podcast.
I'm founder and host, blaiseDelfino, and, as a friendly
reminder, this podcast isseparate from my work at Starkey
.
I'm your host, blaise Delfino,and I hope you're all having a
(01:00):
wonderful week.
If you're listening to this, itmight be morning, afternoon,
evening.
Either way, thank you forlending your ears and thank you
for joining us on our mission toraise awareness of the
importance of hearing healthcare.
And whether you're a studentstudying speech pathology or
audiology, you're a privatepractice owner, ent, or even a
(01:22):
current or future hearing aiduser, we welcome you with open
arms and we hope that thisplatform assists you in making
an educated decision regardinghearing health care.
I've been reflecting a lot,especially when I was practicing
full-time as a private practiceowner and hearing instrument
specialist, and every December31st, especially before the new
(01:45):
year, I would look at our keyperformance indicators, most
commonly referred to as KPIs,and I would always look at
specific numbers, but, mostimportantly, our return for
credit rate or RFC, and one ofthe reasons I looked at that was
not because to say, oh you know, only 10 patients this year
(02:08):
returned their hearing aids.
That's great To me when apatient would return their
hearing aids.
I took that very personallybecause I love what we do.
As hearing care providers wereto return their hearing aids, I
felt as though I had failed them, especially if they had a
severe hearing loss, and Ipersonally learned not to take
(02:29):
it personally.
We always walk through.
But I will say full disclaimerhere.
Our return rate was less than1% and I don't share that to
brag or boast or to impress you,but rather impress upon you
that I do know what it feelslike when a patient returns
their hearing aids.
Some are not ready, some it istruly a financial aspect, but we
(02:52):
learned quickly to reframe howwe were speaking with our
patients, our service deliverymodel, our patient experience,
and that's why we have and hadsuch a low return rate.
So again, that number, I lookedat that and if we had a low RFC
, what that told me is we havehappy patients that are telling
(03:12):
their friends about their newhearing journey and that's also
showing that our team is allwalking in lockstep.
We're all walking together inthe same direction, helping
patients hear life's story, andI really felt it in my heart of
hearts to talk to you today anddiscuss ways in which you can
reduce hearing aid returns.
(03:34):
Now we are this band of hearingcare providers that truly are on
a mission to raise awareness ofthe importance of hearing
health care, and we have a lotof work to do.
We need to continue to removethe stigma and oftentimes new
hearing aid users, when theycome into the clinic, they might
be a little skeptical and theyare going through that grieving
(03:55):
process and, I can assure you,embodying empathy.
So, ways in which we canimprove our return for credit
rate.
Now, again, we want to have alow RFC rate, a low return for
credit rate.
If we have 50% of our patientsreturning their hearing
instruments, the problem isprobably the individual looking
(04:18):
at you in the mirror.
We don't want 50, 60, 70%because, again, it's also not in
the best interest of thepatient.
Don't want 50, 60, 70 percentbecause, again, it's also not in
the best interest of thepatient.
But I know that you listening,right now you have a low RFC
rate.
So, number one, how to improveour return for credit rate.
Are you, and is your clinic,offering appropriate financing
(04:39):
options?
Now, today, access is a buzzwordin the hearing health care
space.
We talk about access totechnology, access to hearing
healthcare, and we do have manyplatforms that do provide access
to hearing healthcare andhearing care providers.
But are you, the hearing careprovider, offering appropriate
financing options to yourpatients?
(05:01):
There was a study that wasconducted and these findings
were released on January 2nd2023.
And it writes Americans arefalling short on the savings
front.
According to the State ofPersonal Finance in America 2022
, a study conducted by RamseySolutions, there's a clear
shortfall in personal savingsamong millions of Americans.
(05:24):
The study revealed that 36% ofall Americans have absolutely no
savings at all, and another 19%have less than $1,000 saved.
Just 45% of all Americans have$1,000 or more in savings.
Now, the reason I bring that upas hearing care providers, we
(05:47):
also have to embody financialliteracy, especially if you are
running a private practice,because numbers really do tell a
story.
But one way to reduce yourreturn for credit rate is to
offer these appropriatefinancing options, because what
that study just showed us isthat there are going to be
patients that come to us that donot have liquid funds to pay
(06:13):
for their hearing technology.
So we need to ensure that weare sensitive to that.
We know, as hearing careproviders, that the cost of
untreated hearing loss isgreater than the price of the
hearing technology, but we alsohave to be understanding and
aware that not every patient,even if they that the cost of
untreated hearing loss isgreater than the price of the
hearing technology, but we alsohave to be understanding and
aware that not every patient,even if they need that premium
technology, will be able toafford that.
(06:33):
So I challenge you to audityourself, audit your practice.
What financing options areavailable to my patients?
Am I working with anorganization like a care credit?
What are the terms?
I understand as a hearinghealthcare practice?
It costs you to offer financingoptions.
(06:55):
But again, that is one of thosecosts of doing business and
reflecting with you and yourteam who set those price points,
ensuring that it is not onlyfair to your practice but also
the patient in terms of whatfinancing options are available,
whether it be that 12-monthterm, 18-month term or 36-month
(07:16):
term.
So what is going to help thepractice, what is going to help
the patient and what is going tobe that appropriate middle
ground.
The second way to improve yourreturn for credit rate is
implementing motivationalinterviewing.
Are we asking the rightquestions?
I always loved implementingmotivational interviewing
(07:40):
because number one, you reallyget to know the patient much
deeper than just asking do youhave ear pain, yes or no?
That's what the patient intakecan answer, all of those yes or
no questions, those close-endedquestions.
With motivational interviewingwe're really getting deep in
terms of those open-endedquestions.
(08:01):
How is this patient feeling?
What is their motivation levelto engage with hearing
technology, to even make thedecision today to walk out with
hearing technology?
And when you are implementingmotivational interviewing, this
is usually when you bring thepatient back to the audiology
(08:22):
suite before you test theirhearing.
If the patient brought withthem a family member or a spouse
, or they had a third party withthem, I would always ask the
patient Mrs Smith, what wouldyou like to accomplish today?
And that was always the firstquestion I asked.
And then I would look to thespouse or the third party and I
(08:43):
would ask him or her what wouldyou like to accomplish today?
And after that question, prettymuch nine times out of 10, the
patient would say I've never hada health care provider ask me
what I wanted to accomplish atthe appointment.
And number one you need to begenuinely curious as to why
(09:03):
they're here, what they wouldlike to accomplish today,
because if they walk out of theclinic feeling as though that
they haven't accomplished whatthey came to accomplish, they're
not going to have that sense offulfillment.
So your job as that hearinghealthcare provider is to ensure
you're providing them thatplatform to accomplish what they
wanted to.
Nine times out of 10, especiallyif it were the husbands, it
(09:25):
would say.
I want to prove to my wife thatit's selective hearing and
we've heard that so many timesbut ensuring that you make them
feel comfortable, upfront duringthe motivational interviewing
process and you're asking theright questions.
And that would then follow upby understanding and asking them
(09:46):
what a typical day like is forthem, especially as it relates
to communication.
On a scale of 1 to 10, 1 beingyou're not socially active to 10
you're very socially activewhere would you put yourself
today?
Well, I'd probably put myselfaround a 4 or 5.
Tell me about your socialactivity level 10, 15, 20 years
ago, before you started tosuspect that you presented with
(10:08):
hearing loss, oh, I was at a 10.
So now we understand, we knowwhere to go.
Now there are patients that maybe introverts or ambiverts, but
again, this motivationalinterviewing allows you upfront
to really deep dive andunderstand.
Is the patient motivated to dosomething about their hearing?
Are they here because theirspouse pushed them?
(10:28):
You're still going to give thispatient 110%, but there are
patients who are truly just notready to take that step towards
better hearing.
A third way that you can improveyour return for credit rate is
appropriate onboarding andfollow-up schedule for the
(10:50):
patients just fit with hearingtechnology and patients who have
been wearing hearing aids for10, 15, 20 years.
When we talk about onboardingand follow-up schedule, first
and foremost, when we started inprivate practice full-time, and
especially following graduateschool in 2017, we knew that by
the year 2020, the majority ofconsumers would make their
(11:13):
purchasing decisions based onthe experience that they had,
and we asked ourselves and weaudited ourselves.
Sometimes it's very hard tolook inside the picture or
inside the jar.
What are we doing right now?
That is not the best experiencefor patients.
What can we do startingtomorrow?
What is that low-hanging fruitthat we can start to implement
(11:35):
to create the best patientexperience possible?
And it came down toimplementing an onboarding
schedule and experience that ourpatients absolutely love.
So what does that look like?
When a new patient moves forwardwith hearing technology, we
send them home with a folderthat is branded to our practice
(11:58):
and then inside that folder weincluded information about
today's visit, information aboutthe technology that they're
moving forward with.
We included one of our mostrecent quarterly newsletters so
this patient could go home andread more about the hearing care
provider and hearing carepractice that they're moving
forward with.
(12:18):
And this is really how theHearing Matters podcast came
about.
Because we started this podcastsolely for the patients that we
were fitting in the clinic.
Because if a patient would gohome and have questions, we
wanted to record episodes thatthat patient could go back and
listen to, especially if theywere moving forward with a
specific hearing aidmanufacturer you know we've
(12:40):
talked about the differenthearing aids available or if
they want to understand whatwe're going to accomplish at
their first follow-up, werecorded an episode all about
their first follow-up.
So, coming into that fittingappointment, for example, that
patient knew what we were goingto cover and what it did.
Is it decreased majority of thequestions and I will tell you 80
(13:04):
to 90% of the new patients thatwe fit with technology.
Whether it was the patientlistening to the episode or
their spouse or third partymajority listened to the episode
and it was a lot of fun.
Our patients said, wow, like Ican't wait to listen to next
week's episode.
So what you were doing is youwere creating an experience and
we were creating an experienceand a community and a platform
(13:27):
for our patients to feeleducated, welcomed and there was
no smoke and mirrors, right, asa consumer.
Let's just say you go topurchase a new vehicle and the
dealership doesn't show you howto use any of the buttons in
this car that you know today'svehicles.
They look like spaceships nowinside.
(13:47):
So like what does this buttondo?
What does that feature do?
As hearing healthcareprofessionals, it is our duty
and responsibility to focus onthe benefits of the hearing
technology first and the featuresecond.
But what does that onboardingschedule look like?
So we always, of course,implemented their fitting
appointment first follow-up,second follow-up.
If they felt as though thatthey needed a third follow-up,
(14:10):
of course, we satisfied that,and then, every six months, we
saw them for a clean and check.
So we're seeing our patients atleast following that onboarding
schedule two times a year atleast.
The patients did incrediblywell and again, this absolutely
positively influenced andimpacted our very low return for
(14:34):
credit rate.
I will tell you we implemented asystem.
We created a system.
We created a system and I wasnever afraid of Mrs Smith coming
back to the hearing care clinicwith her manufacturer bag in
hand, not wearing the hearingaids, saying I came to return
these.
What this system and processdid, not only for me as a
(14:57):
hearing care provider, but forour team, is it increased our
confidence.
So if we take a look at this,you know you have a low return
for credit rate.
You're offering appropriatefinancing options, you're
implementing motivationalinterviewing and you have a
system that ensures that thepatient is onboarded properly.
Just these three things alone.
(15:19):
If you implement, you will seea drastic decrease in your
return for credit rate.
The patients felt part of aprogram versus a transaction.
With our onboarding andfollow-up schedule, think about
the last time you felt as thoughyou were truly heard at a store
or a shopping experience.
It could be a healthcareprovider as well.
(15:42):
Did you feel heard?
Did you feel part of a programor did you feel as though it was
just a transaction.
We are human beings and we aresocially connected.
We are social beings.
We want to feel part ofsomething, especially in the
hearing healthcare industry.
There is no industry like ours.
We can never turn our hearingoff, it is always on.
(16:04):
And our patients, when theystart to sense that decrease in
hearing, oftentimes they maystart to experience that loss of
self, and that's where grievingcomes in.
So, if anything, we discussedtoday the ways in which to
decrease your return for creditrate.
This is number one.
This is really, reallyimportant that you create a
(16:27):
system and or refine yourcurrent system to ensure that
the onboarding schedule is firstclass.
We would always follow up too.
When a patient was fit with newhearing technology, we sent them
a thank you card.
It's those little things.
New hearing technology we sentthem a thank you card.
It's those little things.
And that thank you card handsigned, oftentimes handwritten.
Because, if you go back to thebasics, we live in a world of
(16:50):
artificial intelligence and it'sphenomenal technology.
The hearing aids use AI andit's friendly AI, but we, as
hearing healthcare providers andbusiness owners, private
practice owners, cannot losethat human touch.
Blaze, I don't have the time.
I get it.
We all have 24 hours in the day.
However, can you pre-sign someof these thank you cards and
(17:12):
your front office staff fillthem out?
So it's those little thingsYou've never been bitten by an
elephant, but you've been bittenby a mosquito so it's the
little things in business andlife that really come back to
bite us.
The fourth way to improve anddecrease your return for credit
rate is drumroll, please.
Implementation of best practices.
(17:33):
We are not going to deep diveinto this today, because you, as
a hearing health care provider,know you should be conducting
speech and noise testing, videootoscopy, tympanometry,
otoacoustic emissions,functional gain testing, real
ear measurement.
Those are just a few bestpractices that we, as hearing
care providers, should beimplementing.
(17:54):
When you implement bestpractices and one of them,
absolutely a tool that we'veused and continue to use, is the
use of the AFAB, theAbbreviated Profile of Hearing
Aid Benefit how is theimplementation of best practices
, blaze, going to reduce myreturn for credit rate?
Here's how.
When you implement bestpractice, you know that you are
(18:17):
hitting their targets for bestspeech and understanding.
When you do real earmeasurement, when you implement
tympanometry, you know thattheir middle ear space is
functioning appropriately.
You know what their speech andnoise testing scores are.
So what you're going to do isincrease some of that digital
noise reduction.
Reduction the implementation ofbest practices allows you to
(18:39):
fine-tune the hearing technology, but also understand.
What additional communicationmethods do I need to discuss
with this patient to ensure thatthey're hearing to the best of
their ability.
When you do that, the patientis going to be happy.
They're going to feel heard.
They're going to feel part ofthe community with which they
once were able to communicate in, but maybe they've recently
(19:01):
withdrawn, or the past yearshave withdrawn, and what they're
going to do is tell theirfriends and family about their
new hearing world.
And if a friend or familymember of this said patient also
feels as though that theypresent with a hearing loss,
they're most likely going tocall you.
Which again?
A decreased return for creditrate or a low return for credit
(19:22):
rate.
What that also carries overinto is increase in patient
referrals, because your patientsare happier and your practice
is going to continue to help somany community members.
Let's talk about the fifth wayto decrease return for credit
rate.
To decrease return for creditrate, set realistic expectations
.
This is really, reallyimportant to do, and the reason
(19:49):
why is because when you areworking with patients and you're
setting realistic expectations,your patients have this
guidepost of okay.
My hearing care provider told methat the goal of a hearing aid
is not to make everything louder, it's to make speech clearer,
and I am not going to havesupersonic hearing with these
hearing aids.
The hearing care provider alsotold me that there are sounds
(20:11):
that I've heard before that maysound a little louder the first
week or two.
Some sounds may sound harsh,but my brain is going to
acclimate to this new hearingworld.
I really wanted to talk to youtoday about you know when you
set these realistic expectations.
If I were to say, mrs Smith, weneed to set realistic
(20:31):
expectations here, well, thehearing technology today is
incredible and you have theseamazing features like biometrics
and fall detection incredibletechnology.
The goal of the hearing aid isto help you understand speech
clearer, not only in simple butcomplex listening situations
(20:51):
like a restaurant, bar area orjust around family during the
holidays, but also thetelevision.
So we set realistic technologyexpectations.
We set realistic listeningexpectations, and the patients
would always say thank you fordoing that, because we also have
to understand that this patienthas been grieving.
(21:12):
They are looking for somerelief If we shoot for the stars
and we over-promise what thetechnology is going to do for
them.
Number one it's not in the bestinterest of the patient because
when you set unrealisticexpectations, they're going to
get frustrated and guess what?
They're going to return theirhearing aids.
Who cares about the return?
What I care about is thispatient who has been struggling,
(21:35):
maybe for a few years, who isnow not wearing technology, and
we understand the comorbiditieslinked to untreated hearing loss
.
So, as hearing healthcareproviders, it is our duty and
responsibility to set theserealistic expectations.
When you're setting realisticexpectations, oftentimes this
conversation leads into thepatient maybe asking well, how
(21:59):
long do I have to try thehearing aids?
What we did is we replacedtrial period with adjustment
period.
So we would say Mrs Jones, youhave a 30-day adjustment period.
What this allows us to do as ateam is to ensure that you're
satisfied with your new hearingworld.
(22:20):
We're going to make adjustmentsto the hearing technology and
we're going to track yourperformance, not only with the
hearing technology, but from acommunication standpoint as well
.
I would encourage you replacetrial with adjustment period.
Last but not least, the sixthway to decrease your return for
(22:42):
credit rate and improve this KPIis to recommend appropriate
hearing technology.
So when you've implemented bestpractices and the patient has a
92% word recognition score, butthey have a severe speech and
noise score and they have a veryactive lifestyle and they're 65
(23:06):
.
You're most likely going torecommend premium hearing
technology.
However, that's also where thatappropriate financing option
comes into place.
This is where you talk aboutthe price of the technology,
what comes with that, warranty,et cetera, et cetera.
I'm not going to tell you howto run your business from a
warranty standpoint or a pricingstandpoint.
(23:26):
That is between you and yourbusiness only.
But when we are recommendingappropriate hearing technology
and we are leading with highstandard of care, what does that
mean?
What does that high standard ofcare mean?
We need to make the bestrecommendation for the patient.
Oftentimes I've heard of storiesat different conferences and
(23:47):
conventions where providers willsay my patients will not spend
X amount for premium technology,so I always offer mid to lower
tier hearing technology.
I can understand the reasoningbehind that, but I also believe
that you are taking away theopportunity for your patient to
(24:07):
hear even better with premiumtechnology.
So if you recommend, let's justsay okay.
Mrs Smith, we know that youpresent witha significant
hearing loss and you told methat you live a very active
lifestyle.
Your goals are to understand.
In restaurants, in meetings,your husband expressed to us
(24:29):
that he wants you to hear betterwhen you go out to dinner, when
he takes you out to dinner andpicks up that bill.
Right.
Based on your significanthearing loss, your social
activity level and what youwould like to accomplish, I am
going to recommend the premiumhearing solution that we have in
the clinic which costs X, andthen what you do is you stop
(24:52):
talking and implement wait time.
When you do recommendappropriate hearing technology
and your case presentation iseducational, not transactional.
Again, that patient is actuallymaking the decision, as they
should be.
You're that guidepost.
Oftentimes they're going tomove forward with your
recommendation.
If you change the paradigm of Iam providing so much value.
(25:16):
This patient is going to hearso much better.
They're going to communicate somuch value.
This patient is going to hearso much better.
They're going to communicate somuch better.
The goal here as a hearing careprovider is to again educate
them.
We know that they're going tohave their technology for quite
a few years Now.
That's where that appropriatefinancing option comes into play
.
If the patient truthfully cannotafford premium hearing
(25:39):
technology, discuss lower tiertechnology.
But again, you need to thenreset those realistic
expectations.
If you go from a premium tomid-level device, well, you have
a severe speech and noise score.
If we go with the mid-leveldevice, this is what you can
expect.
If you are going into a lowertier technology device, this is
(26:00):
what you can expect If you aregoing into a lower tier
technology.
Please recommend and everyprovider should be doing this
including a remote microphone toincrease that signal to noise
ratio, and that should bewhether it be low, mid or
premium technology.
So again, six ways to improveyour return for credit rate and
reduce your RFC.
Because, again, your return forcredit rate and reduce your RFC
(26:23):
?
Because, again, yes, we want toensure that our practice is
thriving and we're able to helpas many patients as possible.
One of the reasons we want toreduce the return for credit
rate is because there's millionsof individuals out there with
hearing loss.
We want to show up for themevery single day and by doing so
, they are going to be happypatients, they're going to be
(26:44):
champions of better hearing andthey're then joining our mission
to raise awareness of betterhearing.
Thank you again for joining usfor another episode of the
Hearing Matters podcast.
Today we discussed ways inwhich we can reduce hearing aid
returns, not because it's what'sin the best interest of the
practice, but because it is whatis in the best interest of the
(27:07):
patients.
I'm your host, blaise Delfino,and until next time, hear life's
story.
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