DSMES is a collaborative process through which people living with diabetes gain the knowledge and skills needed to modify their behavior and successfully self-manage the disease and its related conditions. This process incorporates the needs, goals, and life experiences of the person with diabetes and is guided by evidence-based standards. DSMES is a reimbursable service that pharmacists are actively being paid for on a Medicare, Medicaid and Commercial Payer level. To bill for this service, a pharmacy must first acquire the Association of Diabetes Care & Education Specialist (ADCES) accreditation.
The Need – http://www.ncsl.org/research/health/diabetes-health-coverage-state-laws-and-programs.aspx
The Solution – OmniSYS offers the #1 consulting pathway in the nation for pharmacies to receive ADCES Accreditation (https://www.diabeteseducator.org/).
- ADCES Accreditation is required by insurance payers to receive reimbursement for DSMES. This accreditation is designated for and assigned to your pharmacy/entity. If you are an individual interested in becoming a Certified Diabetes Educator (CDE), more information about that separate certification is found on the ADCES website.
- To obtain accreditation, a pharmacy must also subscribe to the Strand-Rx platform and pay an additional one-time fee of $1200.
- This fee includes a step-by-step checklist and successful pathway, a bi-weekly conference call, best practices shared, disease state-specific curriculum, patient-facing resources, documentation training within the Strand-Rx platform, as well as our staff building your accreditation manual which is about 90% of the paperwork.
- With an engaged pharmacist, this accreditation may be obtained within 12-16 weeks from start to finish.
- The ADCES charges an $1100 application/accreditation fee at the time of application/compliance manual submission.
- If multiple locations are owned by the entity/owner and will also be a location for these services, the primary location should obtain accreditation. As long as the other locations are located in the same state, those locations may be added to the accreditation as satellite locations. In other words, not every location needs to obtain accreditation. The ADCES charges $100 per satellite location and does not charge a fee to add a community location onto the accreditation, such as a church, community center, etc.
- Once accreditation is granted, a licensed technician who is current with diabetes-specific CEs can be the educator of the program. The educator does not need to be a pharmacist, although the pharmacist will act as the DSMES Quality Coordinator.