Get the free Custom Diabetic Insert Order Form - Pine Tree Orthopedic

175 Park Street Livermore Falls, ME 04254 Phone: (207) 8975558 Fax: (207) 8971117info pinetreeorthopedic. Combustor Diabetic Insert Order Form Lab Use Only Doctor/Facility: Address: DI: / / Phone:()

How to fill out custom diabetic insert order

How to fill out custom diabetic insert order

1. Start by gathering all necessary information such as the patient's personal details, medical history, and specific requirements for the custom diabetic insert.
2. Make sure you have the prescription from the healthcare provider for the custom diabetic insert.
3. Contact a reputable diabetic insert manufacturing company that offers customization services.
4. Provide the manufacturing company with the required information and prescription.
5. Follow any additional instructions provided by the manufacturing company, such as taking accurate measurements of the patient's foot or submitting any relevant medical reports.
6. Review and confirm the order details, including the specifications of the custom diabetic insert and the pricing.
7. Make the necessary payment for the custom insert, either through insurance or self-payment.
8. Wait for the manufacturing company to produce and deliver the custom diabetic insert.
9. Once received, carefully inspect the insert to ensure it meets the required specifications.
10. If any adjustments or modifications are needed, contact the manufacturing company for assistance.
11. Instruct the patient on how to properly use and care for the custom diabetic insert.
12. Schedule follow-up appointments to monitor the effectiveness and comfort of the insert.

Who needs custom diabetic insert order?

1. A custom diabetic insert order is typically needed by individuals who have diabetes and require specialized foot support.
2. This may include patients who have specific foot conditions, such as flat feet, high arches, ulcers, or foot deformities caused by diabetes.
3. Custom diabetic inserts help alleviate pressure points, provide cushioning, and support the feet, reducing the risk of foot complications or injuries.
4. These orders are usually made in consultation with healthcare providers, such as podiatrists or orthopedic specialists.

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What is custom diabetic insert order?

A custom diabetic insert order refers to a form used to request specially made inserts for diabetic footwear that are tailored to an individual's foot structure and medical needs.

Who is required to file custom diabetic insert order?

Healthcare providers, such as podiatrists or physicians, are typically required to file custom diabetic insert orders on behalf of their patients.

How to fill out custom diabetic insert order?

To fill out a custom diabetic insert order, the provider needs to provide patient information, specify the type of inserts needed, and include diagnostic codes to support the medical necessity.

What is the purpose of custom diabetic insert order?

The purpose of a custom diabetic insert order is to ensure patients receive appropriate orthopedic support that can help prevent complications associated with diabetes, such as foot ulcers.

What information must be reported on custom diabetic insert order?

The order must include patient demographics, diagnosis, specific requirements for the inserts, and referrer information.