What is it?
The Diabetes Disease Management Program provides information and tools to Sanford Health Plan members about diabetes and their lifestyle. The information includes topics such as diabetic insurance coverage benefits, blood sugars, nutrition, medications, exercise, recommended tests and more. Members are asked to complete a health risk assessment to identify any special needs and to customize their educational materials. The program also includes quarterly educational mailings, an offer for a free glucometer, RN phone calls and more.
Diabetes Disease Management Program Providers
How do I refer a patient?
Sanford Health Plan identifies eligible members through claims, Case Management, Worksite Wellness screenings and also encourages practitioners to send referrals to our Disease management programs. By completing and returning the referral form to Sanford Health Plan, you are partnering with us to provide the best possible care to our members - your patients.
Disease Management Practitioner Referral Form
Information, Resources and Tools
Diabetes Benefits
Members can obtain information on diabetes covered benefits by calling Member Services at 605-328-6800 or 1-800-752-5863, Monday – Friday, 8:00 AM to 5:00 PM CST.
Diabetes Assessment Center
Sanford Health in Sioux Falls is now home to a diabetes assessment center. The clinic-based program is located on the second floor of Ann Berdahl Hall on the main Sanford USD Medical Center campus. It's the only program in the region operating as a "one stop shop" for a diabetic patient. This new assessment center will be staffed with experts in diabetes screening, education and health care. They will work with each patient to help prevent complications. They'll also work with patients to create a plan for their treatment options. The assessment appointment lasts about three hours. Results from the screening are reported to patients and their primary care provider for follow-up care. Patients need a physician referral before a visit to the diabetes assessment center. For more information, patients can call 605-328-0070.
Diabetic Eye Exam Copay Waive
(For commercial, elite1 and Sanford Health members only - please contact Member Services at 1-800-752-5863 to see if your patient is eligible for this offer) To encourage our diabetic members to receive proper eye care, Sanford Health Plan continues to waive the copay for its diabetic members for their annual diabetic retinal or dilated eye exam. We hope that this will help persuade some members to see an eye care professional who might otherwise find it financially difficult.
In order for the member's annual diabetic eye exam claim and copay to be reimbursed properly, the claim needs to be submitted with one of the CPT codes below in conjunction with one of the diagnosis codes below (only one copay per year will be waived):
CPT Codes: 92002, 92004, 92012, 92014, 92018, 92019, 92225, 99203-99205, 99213-99215, 99242-99245
Primary Diagnosis Codes: 250.00 through 250.9
ATTENTION EYE CARE PRACTITIONERS: Sanford Health Plan is concerned with ensuring the continuity and coordination of care of our members with diabetes. In order to improve the lines of communication between our eye care professionals and our member’s primary diabetes care provider, we recommend that your clinic utilize this form in providing your patient’s primary diabetes care provider with information related to their diabetic eye exams.
Diabetes Eye Exam Consult Form
Clinical Practice Guidelines for Diabetics
Diabetes Type 1
Diabetes Type 2
Diabetes Care Flow Sheet
Important Events/Observances
November is American Diabetes Month®, a time to bring even greater awareness and attention to the seriousness of diabetes, its deadly complications, and the importance of proper diabetes control.
To see a complete listing of Events Click Here
For more information: www.diabetes.org |
