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What are the benefits of ordering shoes from SafeStep?SafeStep offers easy ordering of shoes by Apex, OrthoFeet, Soft Spots and Pedors at prices ranging from $64.75 to $105 INCLUDING three pairs of Medicare approved inserts. There is no cost to register and we send you a free sample shoe, measuring stick and catalogs. SafeStep offers FREE electronic Medicare billing and on-line tracking of all orders. Additionally, we can obtain the required MD “Statement of Certifying Physician” and offer annual reminders to patients to return to your office for new shoes each year. Back to TopWhat must I do if my Medicare DME number has expired?If your Medicare DME supplier number has expired, a complete application must be mailed to the National Supplier Clearinghouse to reactivate the Supplier account. When registering with SafeStep, include your old DME and tax ID numbers. The required Medicare forms can be mailed by SafeStep upon request. Back to TopIs a DME Supplier number required to use SafeStep?A DME number is not required to use the SafeStep program; it is only required if you would like us to provide complimentary electronic Medicare billing. We carry shoes by Apex, Soft Spots and Pedors at the manufacturer suggested prices. You will find that this offers significant savings over some other Medicare diabetic shoe programs. There is no cost for registration. If you are only interested in ordering shoes and inserts, you will simply be requested to send a signed billing agreement so that we keep you credit card number, securely on file. Back to TopWhat must I do if I have a DME number and am opening a new office?DME Supplier numbers are location specific; it is necessary to complete a new application. Back to TopWhy do I need to complete the CMS 855 form if I already have a DME number?The CMS 855 form needs to be completed to register for a DME Supplier number, to add a Billing Company, reactivate an expired Supplier number as well as to renew a current Supplier number. Back to TopWhat are the Medicare requirements for coverage of molded shoes?Medicare requires that for molded shoes that the severity of the foot deformity be such that the foot and the appropriate insert cannot fit into depth shoes. Appropriate documentation should always be included in the patient’s chart to substantiate the use of this higher priced item. Back to TopMust I obtain a new Prescription and Statement of Certifying Physician each year when a patient gets shoes?According to the Medicare Supplier Manual, "A new order is not required for the replacement of an insert or modification within one year of the order on file. However, the supplier's records should document the reason for the replacement. A new order IS REQUIRED for the replacement of any shoe. A new order is also required for the replacement of an insert or modifications more than one year from the most recent order on file." "A new Certification Statement is required for a shoe, insert or modification provided more than a year from the most recent Certification Statement on file." So, the bottom line is: 1. Benefits are per CALENDAR year. 2. A new order (prescription or notes in patient's chart) is required for each new pair of shoes regardless of the time since the receipt of the previous pair. 3. The Statement of Certifying Physician is the only thing that is good for a full twelve months and a new one is not required if the shoes are provided in time. Back to TopHow long does it take for shoes to be delivered?Shoes ship directly from the manufacturer one to two days from the time they are ordered. As they ship from the east coast, delivery time ranges from 1 to 2 weeks. Once in a while shoes are backordered. When they are, the manufacturer informs SafeStep and we pass that information on to you. Back to TopIf I already use a billing company for submitting claims and register with SafeStep to register for EDI transmission, will Medicare automatically replace my former billing company?Medicare allows you to register with multiple billing companies. The National Supplier Clearinghouse must receive a copy of the Billing Agreement and an updated 855S form that indicates the billing company. The appropriate DMERC must also be sent a “Billing Addendum” and registration form for electronic claims transactions. Back to TopDoes Medicare cover prefabricated inserts?Prefabricated, heat molded inserts are covered by Medicare for at risk patients with diabetes if the inserts are warmed with a heat gun or toaster oven prior to fitting the patient. Heating makes prefabricated inserts Medicare reimbursable. You have the option of ordering custom molded inserts. Back to Top
How much does Medicare allow for shoes and inserts for patients with diabetes?
For devices dispensed between 1/1/06 and 12/31/06, Medicare allows:
Depth shoes, A5500: $118.75 per pair plus up to three pair Prefabricated heat molded insoles (A5512) at $48.84 per pair or up to three pair Custom Insoles (A5513) at $72.28 per pair.
Custom-molded shoes (A5501) are $356.08 per pair plus up to two pair Custom Insoles (A5513) at $72.28 per pair.
PFA Reimbursement and Government Issues director Janis Gregory suggests keeping the following points in mind: 1. A-codes are not fee schedule items. 2. The law that established the benefit itself set the fees, and it will take another law to change the fees. 3. These are maximum national allowable amounts. 4. Each DMERC may calculate the formula differently, but the amount should not be higher than listed above. The fees usually vary from state to state. 5. All increases from the original pricing are tied to DME (Durable Medical Equipment) increases. Back to Top
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