and Clinics awarded certificate of accreditation
Since 2007, St. Mary’s Hospital and Clinics has provided diabetes education services free of charge to hundreds of people in Idaho and Lewis counties. And, since 2010, two diabetes support groups (held September--May in Kamiah and Grangeville) have provided self-management education, open to all people affected by diabetes. “We hope our diabetes education services have lived up to St. Mary’s Hospital and Clinics’ mission statement of ‘making a healthy difference in people’s lives,’ particularly for those impacted by diabetes,” says Vicki Berg, head of the Diabetes Self-Management Education Program at SMH.
Rural health services are being challenged to keep valued services closer to home. Diabetes Self-Management Education is one of many such services. In order to keep local access to diabetes education, SMHC’s Diabetes SME Program chose to pursue and was awarded accreditation by the American Association of Diabetes Educators in March 2016. This accreditation, recognized by Medicare, Medicaid and most private insurers, confirms that SMHC Diabetes SME Program meets national standards for diabetes education. It also means that diabetes self-management education is a billable service for SMHC and a covered benefit for you and others receiving Medicare, Medicaid and most private insurances.
“Basically, this means that Medicare, Medicaid and most private insurers will pay for 10 hours of initial diabetes education,” explains Berg.“Most people referred by their healthcare provider to SMHC Diabetes SME Program will be entitled to the full 10 hours of initial diabetes education. If the entire 10 hour-benefit is not used within the calendar year, those hours will be lost.”
SMHC’s certified diabetes nurse educator will provide basic diet instruction (i.e., Plate Method, Carbohydrate Counting, Weight loss). However, if patients need or want more specific diet education, Medicare, Medicaid and most private insurers will also pay for 3 hours of initial education with a registered dietitian.
“It also means that once the initial diabetes education is provided and billed (within a calendar year), Medicare, Medicaid and most private insurers will pay for another two hours of follow-up diabetes education and nutrition visits for all participants every year,” says Berg. “It is important to note that for people who have already received initial education elsewhere, any further diabetes or nutrition education will be considered a ‘follow-up.’ The follow-up life-time benefit includes 2 hours of follow-up diabetes and nutrition education every year.”
Copays and deductibles will apply to initial and follow-up Diabetes SME and nutrition education with a dietitian. For those without insurance or unable to pay their copays or deductibles, please call Becky Colwell at 208-476-8018.
Beginning October 1, 2016, SMHC’s Diabetes SME Program will begin billing Medicare, Medicaid and private insurers for diabetes education. “So, whether you’re new to Type 1 or 2 diabetes, pre-diabetes or diabetes during pregnancy or you’ve lived with diabetes for years and need a refresher, your healthcare provider can refer you to SMHC Diabetes SME program,” says Berg. “Unless you’ve received/been billed for diabetes education services outside of St. Mary’s Diabetes Education program, you’ll be entitled to the full initial 10 hours. Otherwise, you’re entitled to 2 hours of diabetes SME every year.”
“We recognize the possible impact this change may have on our patients and the diabetes education program. We value the relationships we’ve developed with you, the communities we serve, and the area’s healthcare providers,” says Matthew Forge, Chief Administrative Officer at SMHC. “We look forward to continuing to serve you by providing quality Diabetes Self-Management Education close to home.”
For questions about SMHC Diabetes SME Program or support groups, callVicki Berg at 208-962-3267 ext. 2532 or email firstname.lastname@example.org.
Vicki Berg shows the Certificate of Accreditation that St. Mary’s Hospital & Clinics received from the American Association of Diabetes Educators.
Photo provided by St. Mary’s Hospital.