What You Need To Know About Dispensing Diabetic Shoes

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Jonathan Moore, DPM

   Training your diabetic shoe coordinator and other ancillary staff is fundamental for achieving success in your practice. The benefit of suppliers like SafeStep is that they will provide webinars and even onsite training to help support and grow your diabetic shoe program. You can prevent re-orders and mistakes the first time by simply having protocols to make sure you choose the right shoe with the right size.

   Be prepared, however, to have patients tell you that they don’t wear this or that size after you have accurately measured them. Some even get fighting mad when you tell them they are truly a 10 and not a 7, which is what they have worn since 1967. Carrying a gamut of sizes of your key shoes can make sure you get it right the first time.

How To Get Patients To Return For Additional Fittings

Another characteristic of a growing diabetic shoe program is a solid patient recall program among your diabetic patient population. This is another key responsibility of your diabetic shoe coordinator and a fundamental requirement for growth.

   While there are many ways to go about doing this, there are important considerations. First, recall letters to your patients in your practice should not be a solicitation for footwear. Your letter should reflect that it is your practice as a diabetic center of excellence and that you perform a comprehensive diabetic foot examination annually for those patients with diabetes. As a part of your comprehensive evaluation, one should perform a thorough assessment of the condition of the patient’s diabetic footwear.

   It is perfectly appropriate to educate your patients that they are eligible for one pair of shoes annually along with three pairs of diabetic orthotics, and that determination of need occurs as a part of your comprehensive diabetic foot examination. You should highlight that in addition to footwear, you assess the patient’s skin, nails, balance and circulation.

   Your recall protocol obviously can vary but it should an ongoing process. It goes without saying that it is common for our diabetic patient population to miss appointments and often fall off the radar due to other medical problems or transportation problems. It would be appropriate that patients fit in the prior year be fit again by July. If not, suggest they return for a risk assessment to determine their eligibility and fitting if appropriate.

   There is no reason why your diabetic shoe numbers should not increase every year with a good recall system.

Final Notes

The last and most vitally important component of a growing and healthy diabetic shoe program is peace of mind that your documentation is compliant with Medicare DME supplier standards. Medicare rules change and can be confusing. Use trusted sources like SafeStep to ensure the documentation you use is compliant and efficient to utilize.

   Dr. Moore is board-certified by the American Board of Podiatric Medicine. He is the Fellowship Director of the Central Kentucky Diabetes Management program, is adjunct faculty at the Kent State University College of Podiatric Medicine and serves on the Board of Trustees of the American Academy of Podiatric Practice Management. Dr. Moore is a managing partner of Cumberland Foot and Ankle Centers of Kentucky.

   For further reading, see “How To Establish And Maintain A Diabetic Shoe Program” in the October 2003 issue of Podiatry Today, “Understanding The Diabetic Therapeutic Shoe Program” in the October 2005 issue or “Secrets To Billing For Diabetic Shoes” in the March 2011 issue.

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