Making the use of DME and the Medicare Therapeutic Shoe Program easier.

Physician Login/Register

Essentials For Diabetic Shoe Fitting Success By Josh White, DPM, CPed

I recently visited a team a podiatrist’s office. They have been a part of the Therapeutic Shoe Program and fitting diabetic patients with shoes for many years. I appreciated their interested in learning how they could improve what could be considered a “good” shoe program, and in going from “good” to “better” or even “great.”

All staff members were encouraged to attend, including: the front office person, who is the eyes and ears of the practice, and who reminds the doctors which patients have diabetes and are due for an annual comprehensive diabetic foot exam (CDFE); the fitting person, who measures, fits and laces patients’ shoes – critical to the program’s success.

We reviewed how the Medicare Therapeutic Shoe Program provides win – win – win benefits for all: patients benefit by getting shoes they need for little or no cost, by doing so, they also decrease their risk for ulceration and amputation, and the office makes money while improving patient satisfaction (and Medicare actually reduces costs).

We reiterated the importance of clearly defining each step in the evaluation and shoe fitting process, and confirmed that while there could be more than one person performing each task, there must be a single person responsible for its execution.

And lastly, we defined the metrics for determining the success of each step – as well as for the program overall.

Here are the steps and how to determine successful execution:

  • Determine the number of patients in the practice with Medicare and diabetes. Every patient should have a dedicated visit for an annual comprehensive diabetic foot evaluation (CDFE) scheduled on a separate visit. This visit can performed by or overseen by the DPM and billed as 99213 if a predisposing condition of ulcerative risk is determined and a plan of care prescribed. Printed copies of the CDFE form are available, for free, from SafeStep upon request. Here is a link to the form: http://safestep.net/safestep/PDF/CDFE(Interactive).pdf?id=431. Note: Someone should track the number of CDFE exams performed (on an ongoing basis), and compare it to the number of patients with diabetes in the practice.
  •  Conservatively, 75% of patients with Medicare and diabetes will have a qualifying risk factor and should be prescribed therapeutic shoes. When scheduling patients, either have a shoe fitting person in the practice available to assist on that day or consider OHI’s Central Casting Program, an on-site Pedorthic service availing Certified Pedorthist to assist podiatrists with examining, casting and fitting patients.
  • Every shoe fitter and CPed should use the “4S’s approach to shoe fitting” which are: Size, Shape, Stability, Style to fit and pair the shoes that meet each patients’ aesthetic desires and therapeutic needs. It’s important to have shoe samples in the styles patients most prefer, and to update them periodically. Fitting displays or a small fitting inventory will go a long way to improve fitting success and patient satisfaction. Patients whose fitting needs exceed what’s possible with depth shoes should either be casted for custom molded shoes or referred to a local footwear clinic. The SafeStep website displays the practice’s “Fit Rate”. If not 85% or better, help is available to fit at least as well as is done by the average office.
  • Use SafeStep’s WorryFree DME program to create Medicare compliance documentation and to procure required authorization from the certifying MD physician. SafeStep’s team of professionals and dedicated services help you save time, and build your practice.
  • When dispensing shoes, emphasize to patients the importance of daily footcare and self-examination to check for signs of ulceration. Encourage them to wear their fitted shoes and inserts as a preventative measure, and to return on an annual basis to be re-evaluated for replacement shoes each year.
  • The true indicators of a successful diabetic shoe program is when the number of shoes fitted increases each year, and the number of wounds treated decreases. While some practices have been deterred from fitting shoes because of the effort required and concerns about Medicare audits, many enjoy the success that this preventative care indicative was intended to achieve. Read the article “Keys for Success for Fitting Diabetic Shoes” to learn more.
  • Qualifying patients should be scheduled for an evaluation and fitted with shoes annually. Despite the benefits, most practices refit less than 25% of patients from one year to the next when all it takes is an outreach effort to patients from each year. Your SafeStep homepage displays the practice “Repeat Rate”. There are tools available, including patient lists, which can be used to facilitate a recall program, to ensure that every patient is evaluated annually to be refit with replacement shoes. To better understand the true value to your practice, read “The $40,000, 4 Hour per Week Diabetic Shoe Program”. The article describes how little time is actually needed, if the program is organized effectively, to yield significant benefits to patients and to the practice.
  • Successful practices set goals at the beginning of each year and monitor their performance on an ongoing basis. To recap, key metrics for ensuring program success include:
    1. The number of annual CDFE’s performed on patients with Medicare. Compare to the number of patients with Medicare and diabetes in the practice. Every patient should have at least one annual evaluation.
    2. The number of shoe fit, covered by Medicare. Conservatively, 75% of patients with Medicare and diabetes will have a qualifying risk factor and should be fit with shoes.
    3. Shoe fit rate. Should be 85% or better. Track on SafeStep Members Home Page. If lower than it should be, assistance is available to help improve.
    4. Refit Rate: Should be 75% by end of year.

Successful practices create incentive programs to reward staff members responsible for each of these key metrics.

  • Further assistance is available by scheduling a One-on-One Training Session with a SafeStep DME Specialist. Topics include:
  • “The WorryFree DME Shoe Ordering Process”
  • Diagnosis Specific DME Treatment Protocols for AFOs
  • AFO and Shoe Compliance Documentation
  • 18 Surefire Ways to Improve Your Shoe Fitting
  • Fall Risk Management Made Easy with Moore Balance
  • The CDFE Strategy

I hope you find this article helpful. I truly enjoy writing these articles and working with practices to help them become more successful. Our friendly SafeStep customer service team is available to assist you with your account and all programs, products, services.

Extra-depth Shoes May Help Alleviate Foot Pain for Older People

For adults over age 65 with disabling foot pain, being fitted for off-the-shelf extra-depth footwear reduced pain and improved function, according to a new study.

This type of footwear is often marketed to people with diabetic foot ailments, for whom Medicare – the U.S. government health insurance program for people over 65 – will cover most of the cost of the shoes.

Click here to read the full article!

Schedule a FREE Training Session with a SafeStep EXPERT to Ensure That Patients Fit With Shoes in the Past are Fit Again This Year

retention-boxSchedule a FREE Training Session with a SafeStep EXPERT to learn how to ensure that patients with diabetes, fit with shoes are, if qualified, fit year after year.  While Medicare offers coverage for replacement shoes each calendar year, in most practices, less than ¼ of patients fit one year are fit the next.  Let us show you how to ensure that patients in need of care get it and also that your practice does not miss out on revenue opportunities.

SafeStep Training Sessions are designed to help your practice grow.  Schedule a FREE one-on-one personalized on-line appointment with one of our trained EXPERTS to make fitting diabetic shoes an important part of your practice.  In one 45-minute session, you will cover:

  • How to benchmark the number of patients in practice who should be fit with therapeutic shoes
  • Establishing office protocol to ensure that patients with diabetes are scheduled for annual risk assessment
  • Tools to reach out to patients fit with shoes in past and not yet in current year.
  • The benefits of outsourcing procurement of Medicare required compliance documentation

At the conclusion of your training session, your SafeStep EXPERT will ensure that you:

  • Determine your “Number”, the number of patients in your practice with Medicare and diabetes.
  • Your office is set up for shoe fitting success
  • Can track your practice shoe fitting success using the SafeStep Practice Report Card
  • Know where more assistance is available.
  • Schedule a follow-up appointment for additional training.
  • Earn your PQRS incentive bonus from Medicare

SafeStep DME Training will help you grow your practice, improve patient care and enhance practice revenue cialis generique fiable.

Good Ulcer Management Reduces Amputation Caused by Diabetes

Aetrex-men

Amputations caused by diabetic complications can be reduced by at least 50%with the use of proper shoe inserts, podiatry care and regular health checkups, according to a study that will be presented at the International Society for Prosthetics and Orthotics World Congress in Hyderabad, India from Feb. 4-7.

The study, conducted by researchers at the University of Gothenburg’s Sahlgrenska Academy in Gothenburg, Sweden, included 114 patients with diabetes who were at risk for developing ulcers. Each participant wore one of three shoe insoles and was monitored over a 2-year period. The researchers found that only 0 cialis pas cher france.9% of the participants developed a new ulcer during the first year.

Continue Reading on Healio.com

 

Study: Diabetic Footwear Not Worn at Home

Patients with diabetes prescribed to wear custom footwear infrequently wear this footwear at home where the largest amount of walking occurs, according to study results recently published in Diabetes Care.

The study included 107 patients with diabetes, neuropathy, a recently healed plantar foot ulcer and custom-made footwear. The researchers monitored footwear use with a shoe-mounted, temperature-based monitor and daily step count with an activity monitor worn on the ankle over a period of 7 consecutive days. Adherence was calculated as the percentage of steps that prescription footwear was worn.

Continue Reading on Healio.com

 

Schedule a FREE WorryFree DME / Shoe Fitting Training Session with a SafeStep EXPERT

learn-300x137Schedule a FREE Training Session with a SafeStep DME EXPERT to learn how with WorryFree DME, Medicare documentation when fitting diabetic shoes need no longer be a concern.

SafeStep Training Sessions are designed to help your practice grow.  Schedule a FREE one-on-one personalized on-line appointment with one of our trained EXPERTS to make fitting diabetic shoes an important part of your practice.  In one 45-minute session, you will cover:

  • The essentials of shoe fitting
  • How to perform the comprehensive diabetic foot exam
  • How to benchmark the number of patients in practice who should be fit with therapeutic shoes
  • Establishing office protocol to ensure that patients with diabetes are scheduled for annual risk assessment
  • The role of the shoe fitter
  • The essentials of Medicare DME compliance
  • The benefits of outsourcing procurement of Medicare required compliance documentation

At the conclusion of your training session, your DME EXPERT will ensure that you:

  • Determine your “Number”, the number of patients in your practice with Medicare and diabetes.
  • Your office is set up for shoe fitting success
  • Can track your practice shoe fitting success using the SafeStep Practice Report Card
  • Determine if it would be beneficial to utilize free electronic billing to Medicare
  • Know where more assistance is available.
  • Schedule a follow-up appointment for additional training.
  • Earn your PQRS incentive bonus from Medicare

SafeStep DME Training is intended to help you grow your practice, improve patient care and enhance practice revenue.

Call 866.712.7837 or email us at info@safestep.net to schedule your FREE individualized on-line session!

<a href="http://safestep cialis livraison rapide france.net/Members/WebinarInfo.asp?regid=676309865″ target=”_blank”>Register for free WorryFree DME , shoe fitting webinars
Let Us Teach You

A Case for Integrating Pedorthists into Podiatric Practices

Podiatrists have traditionally provided referrals to their patients who need therapeutic footwear. However, the opportunity to increase practice revenue, patient desire for “one-stop shopping,” and growing awareness of the Medicare Therapeutic Shoe Program have resulted in podiatrists increasingly making shoe fitting a part of their practices. As podiatrists become more efficient and skilled at fitting shoes and recognize how much they can benefit their patients while improving their bottom line, this trend is expected to continue.

Podiatrists can work most efficiently by creating “practice protocols” whereby commonly seen conditions are directed to and addressed in a routine way by trained office staff. Such an approach lends itself well to fitting patients who have diabetes and are at risk for ulceration with therapeutic footwear. Even before these patients meet with the podiatrist, offices can identify them and provide them with a brochure or information packet that details the role footwear can play in reducing their risk.

Continue Reading…

What is the Best Way to Measure Shoe Size for Patients Wearing an AFO?

Arizona AFOMost any AFO makes shoe fitting more challenging; the bulkier the device, the harder to fit shoes. The most important concept is the importance of fitting from the inside out. That is, the shoes must accommodate the foot, insert and AFO. Shoe design is as significant as size for effective fitting.

Features of shoes best to fit over an AFO:

  • Incorporate rocker sole if propulsive gait and AFO limits ankle and STJ sagittal joint motion
  • Full contact sole that does not taper in midsection.
  • Firm heel counter that do not twist easily.
  • Removable footbed
  • Removable spacers

Shoe styles determined to fit best over AFOs are indicated in the SafeStep shoe catalog and on the website with an AFO icon.

When sized properly:

  • There should be 1/2″ space between the end of the longest toe and the end of the shoe.
  • Ensure that the shoes are wide enough such that the foot does not bulge the lateral side.

Fitting will be best accomplished in the office with the use of a display stand or with pairs of shoes to try on. When the fitting is challenging or if one foot is significantly different in size or shape than the other, its best to refer patient to store where shoes can be tried on over AFO.

Fit may be best accomplished by removing spacers from shoe with AFO and adding to shoe without.

If foot with an AFO much larger and different in shape from contralateral side, best option is custom molded shoes made over AFO. Entails first molding for AFO and then for shoes afterwards. Custom shoes are only covered by Medicare for patients with diabetes or if AFO attaches to shoe. Alternatively, Arizona AFO makes a custom shoe with built in brace called the Closed Toe Walker.

2012 SafeStep Shoe Catalog Online

I am proud to announce we have again made it easier for you to view our footwear collection catalog for 2012 online, with another easy to view and download catalog.

In the catalog, you will find the best brands, the most styles and the greatest comfort shoes and inserts for those in need of specialized shoes for a healthier, more active and more comfortable lifestyle.

To view the catalog, simply access it at the following page:

http://flipflashpages.uniflip.com/3/51945/122455/pub/