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Hearing Aid Upgrade Notice

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This is a patient/practice document. This document allows you to notify the patient, in writing, of their financial responsibilities when the third-party payer contractually allows hearing aid upgrades. Many BlueCross/Blue Shield plans require the use of an upgrade waiver when a patient selects upgraded hearing aids. This form is provided in a Word format.


446 East High Street, Suite 10
Lexington, KY 40507
(866) 493-5544