Hearing Aid Post-Dispensing Evaluation Form Is Required

The Hearing Aid Post-Dispensing Evaluation Form is posted on the DMA website. (See link below) This form is required when billing for new hearing aids. Providers should print and sign this form and have the recipient or guardian sign it. A signed form and the manufacturer's invoice(s) must be submitted for all new hearing aids. They can be uploaded (if the claim is submitted through the NCTracks Provider Portal) or faxed to 919-851-4014.