The Pharmacy Podcast Network is the Pharmacy industry's first audio blog network about the 'Business of Pharmacy'. The Pharmacy Podcast Network is a collection of over 20 different pharmacist's podcasts, discussion, ideas, innovation, and interviews from the brightest minds in pharmacy. We are always expanding our programming to Independent Retail, Compounding, Long-term Care, Specialty, Hospital Systems, and Small Chain Pharmacy Businesses. We're expanding content for Patients and Pharmacy Students and encourage our listeners to submit ideas for future shows. The Pharmacy Podcast Show is about dynamic people in the pharmacy industry making a difference for our profession, customers, and patients.

PHARMACY COMPLIANCE GUIDE (5)

Diabetic Shoes – Do It Right the First Time 

Why would I ever consider doing Diabetic Shoes, Audits, insurance companies, and stinky feet? Is it not worth the hassle?

  • Diabetic shoes is the only preventive medicine Medicare and Medicaid pay for. If done correctly, the process is just that, a process. Just like filling any other prescription.

But it takes so much time

  • Yes, it does take time. But whose time does it take? This is not a requirement for the pharmacist to accomplish. Depending on the type of shoe and the state, a manufacturer trained individual may see and fit a patient for their shoes and inserts.

Then there is always the audits

  • Yes, there is a lot of fraud with shoes. But understanding the audit documentation process and the details the auditors are looking for before you see the patient makes all the difference.

OK, you make it sound simple. Then why are folks dropping diabetic shoes?

It all in the documentation, that is why you must do it right the first time.

Then let’s start at the beginning by asking, who is eligible?

We are talking about Medicare patients billing through their Part B coverage because this is the most restrictive and most audited process.

  • The patient must be diabetic
  • The patient must have at least one of the following conditions documented by their physician
    • History of partial or complete amputation of the foot
    • History of previous foot ulceration
    • Peripheral Neuropathy with evidence of callus formation
    • Foot deformity
    • Poor circulation

Who can sign the prescription for diabetic shoes and inserts?

The patient must see a MD, DO, PA, CNPT or Podiatrist for a face-2-face visit and receive a prescription for diabetic shoes and inserts. Once the prescription is received from the patient, a Detailed Written Order is completed and faxed to the individual writing the prescription requesting their signature and their clinical notes. If the prescription was signed by a PA, CNPT or Podiatrist, then the patient must be seen by a MD or DO for another face-2-face visit and a Physician Certification of Therapeutic Footwear is needed along with their clinical notes.

If the initial visit was with a MD or a DO, then the Physician Certification of Therapeutic Footwear can be faxed with the Detailed Written Order.

You mention clinical notes, pharmacists normally don’t deal with physician’s clinical notes. Why is importation for shoes?

Clinical notes are a Medicare Part B, DMEPOS requirement. Almost all audits are lost on the clinical notes. The pharmacist, fitter or billing clerk do not need to be a medical expert to identify what is needed or the problem in the notes. The notes must state:

  • The patient is diabetic
  • Has an approved medical condition that requires the need for diabetic shoes
  • The patient must have at least one of the following conditions documented by their physician
    • History of partial or complete amputation of the foot
    • History of previous foot ulceration
    • Peripheral Neuropathy with evidence of callus formation
    • Foot deformity
    • Poor circulation
  • Prescription was written for both shoes and inserts.

You mentioned fitter, can all pharmacists fit diabetic shoes and insert?

The fitter is designated by state law, licensure and CMS rules. In every state except Illinois, a Pharmacist Scope of Practice covers the dispensing of a medical device with a legal prescription. All that is needed is manufacturer’s training and a training certificate. Pharmacy technician and other staff also require manufacturer’s training and can fit diabetic shoes under the supervision of the trained pharmacist. DME facilities must follow state licensure requirements when applicable and an in most instances will only dispense heat moldable inserts.

When can the initial fitting occur?

The initial fitting can occur at any time after receipt of the initial prescription. The initial fitting is an assessment of the patient to ensure the patient meets the requirements for diabetic shoes and can be safely fitted. The assessment includes the entire foot and every aspect is document. Once the assessment is completed, the fitter and patient pick the best style of shoe and complete the order forms.

Where can the fitting occur?

At your pharmacy, DME facility, assisted living facility, senior center or the patient’s residence. You are not limited to stay within your facility. This is a wonderful way to get into your community.

When is the final assessment / fitting completed?

This is a scheduled appointment. When you have received the diabetic shoes from the manufacturer and have received all of correct documentation:

  • Detailed Written Order
  • Physician Certification of Therapeutic Footwear
  • Clinical notes from all healthcare providers indicating
    • Face-2-Face visits
    • Needs for Diabetic Shoes
  • Orders for Diabetic shoes and type of inserts
  • One of the conditions that authorize diabetic shoes

What happens if you don’t or can’t get the documentation?

You use your biggest resource, contact the patient and ask for assistance. Explain what you need from the specific physician or licensed practitioner and ask if they can call. If it is a document that needs completed, you can give the patient the document and ask them to take it to the physician for signatures. The patients are motivated to get their shoes so they are motivated to their paperwork.

There seems to be a lot of diabetic shoe manufactures and they all have their own documentation and they are all different. Which documents should be used?

Shoe manufacturers are experts in manufacturering diabetic shoes and inserts. They market shoes to suppliers and provide a quality product to be dispensed to the patient. They provide documentation from what they feel is appropriate that meets the CMS guidelines but how up to date is it? There are a lot of regulations that must be followed for all Medicare Part B dispensing. If the claim is rejected, the manufacturer really doesn’t have any skin in the game. They have already been paid. It is always the responsibility of the supplier to follow all of the LCD requirements and CMS regulations.

Jeff, you sound very confident on these processes. Why?

Over the years, I have worked with the shoe manufacturers, CMS, DME MAC auditors, inspectors, accreditation organizations and many other groups. We have developed a deep understanding of what is required to dispense diabetic shoes and more importantly how to win audits. It is always about the documentation. If you know what everyone wants before you start, it is easy to meet the requirements. The problem is all the requirements are not written down. You have to talk to all the people involved. Once you do and the process developed, our process done the right way the first time never has an issue with DME MAC or insurance audits.

So does R.J. Hedges have a solution?

Yes, we actually have several solutions.

First, if the pharmacy is exempt, you can still add diabetic shoes to you CMS 855S application. All you need is manufacturer training and an amended CMS 855S application. There is NO fee

Second, we have a Diabetic Shoe program that focus’ just on the dispensing of diabetic shoes. It comes with all of the documentation, DWOs, Physician Certification of Therapeutic Footwear, Assessments, delivery receipts and compliance training. The cost is $500.00 for the first year and $100.00 for every year thereafter.

Our final option for DMEPOS products is a full DMEPOS compliance program that comes fully customized for the facility. Our sales team will work with the facility to set up the best solution for the program and then one of our Project Managers will be assigned and will create the program and become the facility’s Go To Person or what I like to say, your Assistance Compliance Officer.

Direct download: Diabetic_Shoes.mp3
Category:Pharmacy -- posted at: 7:27pm EST
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Patient's Podcast host Kristy Sobel interviews Sibylle Spühler-Moran who suffered a similar injury and operation as Kristy. 

Sibylle’s Story –Artificial Disc Replacement Failure 

Relentless neck or back pain . . . with stabbing nerve pains . . . can be unbearable and debilitating. We try every alternative therapy until surgery becomes the last remaining option. If you are in this predicament, please listen to my story. It could just change your mind about your next steps.

I’d like to provide you with the INISIGHTS and WARNINGS that I wish I had prior to going down the surgical path. My story is quite complex. However, everyone deserves the truth vs. only partial information, in order to make the right decision.

Please be AWARE of the Spinal Kinetics M6 artificial disc replacement product that will be available in the USA, as soon as the FDA approval is complete. I believed this product was solid and fail-proof, but the exact opposite is true . . . . Their product does NOT live up to their “motion for life” tagline.

 

Direct download: What_you_dont_know_WILL_hurt_you.mp3
Category:Pharmacy -- posted at: 7:02pm EST
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Dr. Christina Tarantola & Dr. Adam Martin return with the Fit Pharmacist Podcast segment part of the Pharmacy Podcast Network. Adam & Christina interview Kamala who holds a PhD in Counseling Education and is a licensed professional counselor, practicing for the last 10 years.

Kamala specializes in grief and loss, marital counseling, depression and anxiety, eating disorders, spiritual formation, life transition, and growing in personal awareness and wholeness. She loves research and teaching and the process of transformation. Fighting for joy and pursuing wisdom with the unique and complex people she meets in counseling is one of the things she enjoys most.  She is also an avid reader, outdoorsy person, a mother of four amazing little people, wife of a pretty incredible fellow, and lover of God.      

 
"Be the change you wish to see in the world"-Ghandi
 
Dr. Christina Tarantola 
Licensed Pharmacist, Certified Health Coach & Author 
The Diet Doc LLC
Direct download: Stress_Management_-_the_Fit_Pharmacist.mp3
Category:Pharmacy -- posted at: 7:14pm EST
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420, 4:20, or 4/20 (pronounced four-twenty) is a code-term that refers to the consumption of cannabis, especially smoking cannabis around the time 4:20 p.m./a.m. (or 16:20 in some European nations) and smoking and celebrating cannabis on the date April 20 (which is 4/20 in U.S. form).

Today's Pharmacy Podcast Episode 420 is a special show dedicated to an update on Medical Cannabis and our GO-TO EXPERT - Joseph Friedman with PDI Medical.

This is Joe's 4th Pharmacy Podcast, our Leading Guest of reoccurring spots for our 420th Episode Published on April 20th 4-20  

  • The History // Explanation of 4-20 ?
  • "State of the nation" from Joe's insights  
  • Latest summary on PDI, experiences, ideas, innovation, conferences, on all things Medical Cannabis  
  • Latest News on the Medical Cannabis front  
 
CONTACT:
 
Joseph Friedman Rph MBA
Chief Operations Officer
PDI Medical
1623 Barclay Blvd
Buffalo Grove, IL. 60089
224-377-9PDI (9734) Office
Direct download: 411_on_420_Medical_Cannabis_Update.mp3
Category:Pharmacy -- posted at: 12:01am EST
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#PharmacyFutureLeaders

3 Year Schools, Kids, and The Business Road in Pharmacy

 

Today we're going to be talking with Shannon Staton Director of Education and Professional Development at RXinsider in Warwick, Rhode Island. Originally from the small seaside town of South Dartmouth Massachussetts, She earned a bachelors and masters in business at the University of Rhode Island and earned her PharmD in an accelerated program at the University of Saint Joseph School of Pharmacy. A three time marathon runner qualifying for Boston with a time of 3 hours 27 minutes and she ran both the 2012 and 2013 Boston Marathons.

  1. Everyone’s leadership road is a little different, yours started in business school, tell us how you got into pharmacy?
  1. You picked a 3-year program and went through with your sister, what was that like?
  1. You mentioned at the end of that term, you were literally holding an infant while you were Skyping in to your last class. What was it like in that last year of pharmacy school, what tips can you give busy parents?
  2. Some pharmacists are looking for alternate careers in pharmacy, some with significant autonomy or creative license, can you tell us about your work at RxInsider?
  1. Does your job involve significant travel? Tell us the pros and cons of a career like that.
  1. We’ve met on LinkedIn, tell me how you use social media personally and professionally including MyCred.
  1. You have a clear passion for working within a creative group, what’s it like to have that kind of group dynamic, how are doing many team projects different than maybe a traditional pharmacy role?
  1. How did the University of Rhode Island prepare you for the work you do? How did the University of St. Joseph prepare you for the work that you do?
  1. You’re a marathoner (so am I, but I’m a 3:50 - 4:10 marathoner), how would you equate pharmacy to running?
  1. I’ve been to Woonsocket, but tell me a little bit about Rhode Island and West Hartford Connecticut, what’s it like to spend college years there?
  1. What blanket advice would you have for new graduates?

Shannon Staton (email: shannon.staton@rxinsider.com)

Director of Education and Professional Development at RxInsider Univ of St. Joseph College of Pharmacy

Phone: 1 774 263 8698 

shannon.staton@rxinsider.com or shannonpharmd@gmail.com

Shannon Staton on twitter @pharmacyinspo

Direct download: PFL_-_Shannon_Staton.mp3
Category:Pharmacy -- posted at: 2:39pm EST
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340B: The Independent Pharmacy Perspective…What you always wished you’d known about the 340B Program

Today we interview Eric Fromhart with 340B consultancy leader Secure340B.

  • What is 340B?
    • Law enacted in 1992 required mftrs to offer discounts to certain eligible clinics and hospitals..
    • Contract Pharmacies—how pharmacies became involved with 340B
    • Review “assumptions” and the “old” way of doing 340B at a pharmacy and how it’s evolved
  • 340B Contract Pharmacy Mechanism
    • Inventory Flow explanation
    • Money Flow explanation
  • How does this impact independent pharmacies?
    • Inventory
    • Cash Flow
    • Rebates
    • DIR Fees
    • Retail gross margins
  • Recommendations
    • We believe 340B can be a great add-on to the pharmacy business. It just must be understood in order to be done right
    • Maximum profitability—“spread”
    • Minimal operational impact to work flow and existing operation
    • Be aware of flexibility
    • Pharmacies see the patients, received the inventory and hold the money—Pharmacy wield the power and control in the program and they need to recognize that

Eric Fromhart
Secure340B
971.322.4935
eric@secure340B.com
secure340B.com

Direct download: Secure_340B_Pharmacy_Podcast_Show.mp3
Category:Pharmacy -- posted at: 10:24am EST
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Pharmacy Podcast Network co-host Blair Thielemier, PharmD, interviews two spectacular pharmacy professionals with Cardinal Health, Genevieve Johnson and Eden Sulzer. 

SHOW NOTES: 

 

  1. Opportunities in community pharmacy 
    1. Independent pharmacy predominantly male and aging - ownership among female pharmacists is 20%
    2. Pharmacy is 60% female
    3. Gap in supply creates opportunity for women to prepare themselves for ownership
    1. Networking
    2. Marketing
    3. Business skills
  2. Development of leadership and business skills 
    1. What you NEED to get started 
      1. Business plan
      2. Financing
      1. Secure financial statements
      2. Identify potential buyers
      3. Game plan with target exit date
      4. Determine value and key drivers that influence price
    2. Key point for transition planning
  3. Creating a plan to achieve your goals


Eden Sulzer is the Director Women in Pharmacy, which she launched in 2011 with the goal of connecting the growing number of women pharmacists with resources, tools, education and support they need to seize the opportunity of independent pharmacy ownership.

Genevieve Johnson is the Central Region Director of Pharmacy Acquisition for the Retail Independent segment. Genevieve earned her Bachelor’s Degree in Business Administration from Pacific Lutheran University in Washington State. Genevieve grew up in her family trucking business where she learned how to drive a 53’ tractor trailer and worked her way up to management experiencing firsthand all of the challenges of business ownership.

She has spent the last eight years at Cardinal Health working with and consulting independent pharmacies. As a leader in Pharmacy Transition Services she assists in the transition of independent pharmacy ownership. She specializes in matching buyers and sellers and facilitating pharmacy valuations. Genevieve is passionate about keeping independent pharmacies independent and understands the value of the personalized care and service that independent pharmacies bring to their communities and patients.

Blair Green Thielemier, PharmD

BT Pharmacy Consulting
Direct download: Cardinal_Health_and_Women_in_Pharmacy_copy.mp3
Category:Pharmacy -- posted at: 1:21pm EST
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Show Notes – How to get More Sponsors for Your Career Development

Dr. Erin Albert interviews - Dr. Harlan Weisman. 

Healthcare Businesswomen’s Association – http://www.hbanet.org

            Indiana Chapter - https://www.hbanet.org/chapters/Indiana

And-One Consulting, LLC - http://www.and-oneconsulting.com

Dr. Weisman on LinkedIn - https://www.linkedin.com/in/harlanweisman

Dr. Weisman on Twitter - @hweisman

Dr. Weisman’s Bio - http://www.and-oneconsulting.com/contact.php

PCORI - http://www.pcori.org

This American Life (Podcast) - https://www.thisamericanlife.org/podcas 

On Being (Podcast) - https://onbeing.org

Testosterone Rex (Book) - http://amzn.to/2oFcIZz

The Mind-Gut Connection (Book) - http://amzn.to/2nd8qsv

I Contain Multitudes (Book) - http://amzn.to/2nFSE4o

The Human Superorganism (Book) - http://amzn.to/2p2Yxdo

The Power of Story (Book) - http://amzn.to/2p2Ym1s

Take our survey on what YOU want to hear about next in pharmacy career development on the Pharmacy Podcast!  https://www.surveymonkey.com/r/RYWXDMZ

Direct download: How_to_get_More_Sponsors_for_Your_Career_Development_2017.mp3
Category:Pharmacy -- posted at: 12:00am EST
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57 Cool Jobs for Pharmacists:

PharmacyPodcast.com – Dr. Erin Albert

LinkedIn Post – 57 Cool Jobs for Pharmacists: https://www.linkedin.com/pulse/57-cool-jobs-pharmacists-erin-l-albert-mba-pharmd-jd

Take our survey on what YOU want to hear about next in pharmacy career development on the Pharmacy Podcast!  https://www.surveymonkey.com/r/RYWXDMZ

Direct download: 57_Cool_Jobs_for_Pharmacists.mp3
Category:Pharmacy -- posted at: 10:36am EST
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#PharmacyFutureLeaders

Preparing for the NAPLEX

Guest: Eric Christianson 

MED ED 101 Clinical Pharmacy Education – Improving Practice, Protecting Patients

Eric Christianson is a clinical pharmacist passionate about patient safety, geriatrics, MTM, and clinical pharmacy. He is the owner of the blog at www.meded101.com a valuable resource for practicing healthcare professionals and students alike who are interested in learning more about the practical application of clinical pharmacy. He has 2 wonderful children and the best wife in the world.

Among his professional accomplishments, he is Board certified in geriatrics and pharmacotherapy, has been quoted in the Wall Street Journal, American Journal of Nursing, written an Amazon best seller Pharmacotherapy: Improving Medical Education Through Clinical Pharmacy Pearls, Case Studies and Common Sense and has helped thousands of nurses, pharmacists, and prescribers become better at medication management.

  1. How do you know you’re ready for the NAPLEX? Number of hours? Practice Tests?
  1. How do you fit in NAPLEX studying as a parent or busy professional or both?
  1. What’s the value of recording yourself?
  1. How do you connect with others during the APPE year?

Contact information you want to share:

www.meded101.com

Twitter: MedEducation101

Blog: www.meded101.com/blog/

Direct download: Pharmacy_Future_Leaders_-_Eric_Christianson.mp3
Category:Pharmacy -- posted at: 11:53pm EST
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