Strategies for Getting Paid for Shoes Through Medicare
Other practitioners have quit dispensing these items altogether . I am the only pedorthist in a nine-county area providing diabetic shoes and inserts due to my competitors bowing out because they had trouble getting paid .
My facility , however , almost always passes Medicare audits . We are a durable medical equipment company and being in a rural area , we cannot afford to go without being paid . As a result , we have worked very hard to make our operation “ audit proof .” That ’ s not to say we never fail an audit , but our success rate is very high by industry standards . Let me share with you how we ’ ve made the system work for us .
1 . First of all , we had to rethink our approach to serving our patients . Before 2012 and the increase in Medicare audits , a person would come into our facility with a prescription from the doctor for diabetic shoes . We would evaluate their feet ourselves , help determine the correct product , and in many cases put them in shoes and heat molded inserts that day . The order was turned in to Medicare and we received our money . Simple and easy .
But then came the announcement that many DME items had been targeted for audits . Among the particular items were diabetic shoes and inserts . At first we floundered around like many other companies . But we stayed in contact with our CMS representative and learned what it would take to pass an audit .
Gone are the days when a patient walks in with a prescription and walks back out with shoes . Now when they come in we still do our foot exam and determine which shoes will work best for them . But then we tell them that this is just the first step . We will
" We are a durable medical equipment company and being in a rural area , we cannot afford to go without being paid ."
18 Pedorthic Footcare Association www . pedorthics . org