Practice Advice

Accounts Receivable Reminder… Save yourself the time writing the check, the cost of a stamp and the risk of the mail…call in your payments via ACH Check--By--Phone for NO ADDITIONAL FEE. Contact Jean or Patty at 1--800--556--5572 for more information or to make a payment.
Accounts Receivable Reminder… When sending payments in, please specify your CUSTOMER NUMBER AND THE INVOICE NUMBERS you wish paid either on the check or in a letter included with your payment. This will help us apply your payments quicker and more efficiently.

Cleaning Tips for Your Display
Ofttimes, the Dr. Comfort display may be overlooked during the normal office cleaning.? A clean and well arranged display rack will help to promote a positive image for your office.? Here are some easy cleaning tips for your display.

1. Check all sample shoes to ensure that they still have inserts – call us if you need some additional inserts for some that may have gone missing

2. Make sure all pairs are matched by size

3. Remove the shoes and wipe each display shelf with a dry cloth or duster

4. If necessary, use a mild, non-abrasive cleaner to remove any smudges

5. Check the nut at the bottom of the display and tighten if it has become loose

6. Return the shoes to the display
Place the smaller shoes towards the top – larger shoes to the bottom
Put shoes that are new – or are your top sellers in the side of the display that is the most visible.
Remember that a clean, well organized Dr. Comfort display is a more effective sales tool for your practice. If you have not upgraded your display to include the newest styles, please call us.

As the Shoe Drops... While caring for patients who qualify for the Diabetic Shoe program, ask them to CHEER for your practice. Patient--to--patient marketing always works! We all need to ask all those happy patients to "BRAG" about the care we provide. Give them brochures, handouts, cards, etc, -all with your name on them. Tell your patients that they are wearing the "Lexus" of the diabetic shoes. Ask them to ask their friends if they are wearing Dr. Comfort. Let your patients know the shoes are not just for diabetics. Tell them that your practice focuses on only the best, and don't their friends and family deserve it! That's good Podiatry!
-Bret Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

What are these blue things in my shoebox? One of the most common issues received by our fitting questions department is that shoes are fitting too big. Upon further investigation, we discover that this is often due to patients wearing our shoes without a proper diabetic insert. Sometimes, patients are wearing just the blue fillers, and this puts the patient at risk for many foot complications. The following should be kept in mind with regard to inserts in the shoes:
Dr Comfort Shoes MUST be worn with either an A5512 (Heat moldable) or A5513 (Custom-made) insert inside. If not diabetic, please see next bullet.
If you are using orthotics, or an insert that is thinner than a diabetic insert, please use the blue fillers to accommodate this difference and maintain fit.
The blue filler is not intended to be worn by itself, as it does not provide arch support, shock absorption, etc.
Dr. Comfort Shoes do not come with inserts unless specifically requested. Make sure your patient will be provided for.
Blue Fillers may also be used to fine tune the fit for patients that are between sizes, or to help avoid the splitting of pairs and associated charges.
If you have any questions regarding our blue fillers or fitting in general, please contact us at 1--800--556-5572, and we will be happy to assist you.

As the Shoe Drops… Take time to reflect…How did the first 6 weeks of the year go? Are you capturing all of your diabetic patients from last year? Have you done any marketing for new Diabetic patients? Is it working? Take your staff to lunch and review your diabetic shoe program. Educate your staff on how to approach non-diabetic patients about trying Dr. Comfort shoes. Take time to reflect and re-aim your office goals. Remember 1 extra pair of shoes each week is a great European vacation. Keeping your patients, staff, and yourself happy and rewarded -that's good Podiatry!
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

FYI… Each year, a new letter of certification from the attending physician (PCP) is necessary for your files. Although there is no change in the patient’s condition, it is necessary to stay up-to-date and maintain audit readiness.

As the shoe drops... Document, Document, Document… No truer words have been written when it comes to dealing with the government and insurance industries. When determining the need for your diabetic patients to participate in the Diabetic Shoe Program, remember to document the medical necessity of a patient needing new shoes. Some examples of this documentation:
The soles show significant wear.
The lateral heel counter is well worn and not supporting the side of the shoe.
Significant lateral heel wear is altering the angle of heel contact.

Keeping diabetic patients in their protective shoes saves feet and that’s good Podiatry!
-Bret Ribotsky, DPM, FACFAS, FACFAOM

Ordering tips…
Orders for Shoes and Elite Inserts
You may either phone these in or fax them to (262) 242-9300 (the fax is the preferred method as this gets the order right into our sales order system). Once the order is received and entered into our system, you will receive confirmation via fax or email from us within 48 hours. If you do not receive this order confirmation, please call us to confirm order status.

Orders for Shoes and Custom Inserts / Toe Fillers
Orders for shoes with custom inserts or toe fillers should include both the Shoe Order Form and the Custom Insert Order Form in the Bio-foam box. These orders are sent directly to our on-site Dr. Comfort Laboratories by UPS. Both the shoes and the custom inserts/toe fillers are entered into the sales order system by technicians in the lab. It is important that these two order forms arrive together as it ensures that we match the orders for shoes and inserts properly. As with the orders for shoes and elite inserts, you will receive an order confirmation via fax or email. If you do not receive this order confirmation within 48 hours, please call us to confirm order status. A duplicate order may occur when the Shoe Order Form for the custom insert/shoe orders is sent with the bio-foam and is then also faxed to Dr. Comfort. While we often catch this duplication, it can sometimes result in a duplicate order being placed on our system for the same shoes. If we don’t catch it – you will get a duplicate shipment of the shoes.

As the Shoe Drops… What's the most famous bird in South Florida? The snow bird <ha, ha>. My community swells to more then twice its size when those retired patients travel south to escape the cold winters. With daylight savings time having arrived early this year, many of my patients are saying bye-bye until next year as they return to their northern homes. This leaves me wondering if I captured each possible patient for diabetic shoes. I have been asking patients to hand out the Dr. Comfort brochure (with my name on it) to their friends, but so far I have no way of determining if this has worked. So this got me thinking….. Next year, I am going to take some actions to change this.
For those of you who live in the North or in communities that have fairly consistent
temperatures, you should consider the following thoughts:
1) Sponsor a lecture on diabetic foot care
2) Buy a pair of shoes for each Endocrinologist in your community
3) Contact diabetic support groups to talk about diabetic shoes.
The more diabetic patients that have good footwear, the less amputations -That's good for Podiatry!
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the Shoe Drops… If you are like me, the paper work is getting out of control. The more I automate processes, the more stuff lands on my desk. Fortunately, when it comes to the Diabetic Shoe Program, most of the required documents are handled by my staff. Today "macros" have become a great time saver for me. I am sure most offices are using some similar repetitive assistance process to assist with the fitting and dispensing visits for patients receiving diabetic shoes. Today would be a good time to re-review these. Make sure you are capturing all of the process your staff is doing to comply with the regulations. Some examples: giving patients' the warranty information, the 21 supplier standards, verifying that the patient can put on and take off their shoes, etc. I realize that all these little details are trifle; but, Michelangelo is quoted as saying "Trifles make perfection, and perfection is not trifle." That's good Podiatry!
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the Shoe Drops… Tax time is coming… I filed my extensions just in case April 16 gets here before I can get everything in order. Now it’s time to get all the documents together! As I was reviewing my end of year AMEX summary report, I was pleasantly surprised to see a year-end bonus for me. First, let me tell you that I place EVERY expense that I can on AMEX. This offers me a few benefits like a) buyer protection on purchases, b) a 30 days interest-free loan until I need to pay, and c) most importantly, "Reward Points".
These "Reward Points" can be transferred to an airline for free tickets, or used for gift cards to places like Home Depot, etc. So while I was reviewing the end of year AMEX report, I noticed that since I paid for all of my Dr. Comfort shoes on AMEX, I earned a lot of points…… Just this past year alone between the shoes, orthotics and the medical & x-ray supplies, I have earned two first class plane tickets' to anywhere in the world. Now that’s a good deal!
I suggest you contact Dr. Comfort and take advantage of this benefit. IT COSTS US, the doctors, NOTHING. Finally, a benefit for the Doctor -That's good for Podiatry!
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

A note on returns… Please make sure you are filling out all of your return paperwork completely then placing each form in the patient’s shoebox with their shoes/inserts. Also be sure you are filling out one form for each patient. This helps us process your return faster, and, in turn, helps you receive credit on your account faster.

As the Shoe Drops… Seminar season is upon us. I am sure that sometime in the next 6 weeks you will be attending a meeting. ACFAS, DFCON, Mid-West, etc., just to list a few, are coming up this month. Since you are spending your time and dollars by attending a meeting, now is a good time to set up some goals to ensure success at the meeting. Successful people plan their day and then live their plan. I have found this tactic to be of great value when attending a meeting to make sure that I am not overwhelmed with the magnitude of the exhibit hall. Before you attend, talk with your staff and determine what you need -research a good price. Then when you "hit" the exhibitor floor, you will be ready to deal and ready to buy – with some leverage. Remember that without vendors, our meetings would cost us thousands of dollars to attend. I will be attending / lecturing throughout the month. Stop me and let me know how you're doing and also let me know if these "snippets" are valuable. Also, stop by Dr. Comfort's booth and let them know how they can help you excel with the Diabetic Shoe Program in your office. Together, we can all set high goals for our practices; then we can surpass them. Our cumulative success is -Good for Podiatry!
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the Shoe Drops… Last month was busy for me -I traveled across the U.S. each weekend to participate in seminars. Thanks to all of you that either attended my presentations or came up and offered comments or asked questions. It seemed that many of you had similar questions. One of the most pressing questions related to the requirements for participation in the DME program. I’ll talk about this more in future faxes, but here are a couple of immediate thoughts.
To begin, compliance with the 21 Suppliers Standards as outlined in CMS Form 855S is a must. (If you need a copy of these, please contact Dr. Comfort). Here are a few that are often overlooked. First, you must have your office hours posted outside of your office (#8). Second, your phone number must be listed in the SAME NAME as your DME number (#9). For example, if your practice is called "Foot Center of _____" and your DME number is issued to Dr. Jones; there is a problem. A quick solution to this is to have one of your office phone lines re-titled to the same name at on your DME Form 855 application.
Staying compliant is the first step in participating in the DME program. Know the rules -That's good for Podiatry.
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the Shoe Drops… It is almost the end of April. Patients who received their new Dr. Comfort shoes in January are almost ready to remove the first pair of insoles and insert the 2nd pair. We all know that this is what patients are supposed to do, but do they? Getting my patients to change their insoles has always been an issue for my practice. Why not just dispense the insoles every 16 weeks? The answer is simple -the government wrote the rules. Nonetheless, we must work with our patients to see that the insoles are switched to reduce the risk of ulceration. So, what strategies can we use to help compliance? Here are a few ideas that may help your practice and provide a terrific “touchpoint” with the patient:
Label each insole with a starting date. Any permanent marker works for this.
Send a post card when the insole needs to be changed. These post cards are inexpensive and can be completed at the dispensing visit.
Send an email reminder to your patients.
Schedule a brief office visit with your staff to assist and verify the switch.There are 1,000's of different ways that this can be done. Choose one, implement it and document it. Keeping patients in their shoes, ulcer-free – Now that's good for Podiatry
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the Shoe Drops… Have you ever looked in the Dr. Comfort Shoe box when it arrives? To be honest, my staff often gets the shoes out and heats the insoles to full contact before I enter the room. Today was different; I opened one of the shoe boxes that just arrived. I was impressed how well it was presented. The shoes were wrapped neatly in "special paper," the insoles and shoe horn sat snugly alongside the shoes, and the Dr. Comfort shoe catalog was placed smartly on top of all of this.
I know I mentioned the value of the catalog in a previous column, but I want to let you know that I continue to obtain extra sales each week from this wonderful marketing piece. Since each catalog has my name already printed on the back, I have zero worry that I am losing any costumers – actually, just the opposite happens – I get some really nice referrals on a regular basis.
Today, I sat back and reviewed the professionalism of the whole thing. This really is well done. I always strive to exude quality, class and professionalism in all that I do, and to that end, Dr. Comfort is my welcomed partner. That's good for Podiatry!
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the Shoe Drops… Surprise Inspection – these could be two of the scariest words we can hear, but they don’t have to be. What prompted this was an event that occurred in my office this week. An inspector from the heath department visited my office for a surprise inspection. My OSHA manual was reviewed. My record for my medical waste disposal and my X-ray chemicals were studied -even my eye-wash station was tested. Thank goodness all was in order.
The inspector told me many offices fail this inspection for not keeping their employee training documentation log up-to-date and also not having their staff vaccinated for Hepatitis B. Compliance is not an option; please make sure all of your logs are up-to-date. Just remember to review and update your office training on OSHA, HIPPA and while you are doing this review Covered Foot Care guidelines and the Diabetic Shoe program at the same time. Providing the best environment for you staff and patients is Good for Podiatry!!
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM Advanced Medical and Surgical Treatment of the Foot and Leg

Remember… Send all remittances/payments to Dr. Comfort, Dept. 5285, P.O. Box 3090, Milwaukee WI 53201-3090 – please include your customer number to ensure prompt and proper processing of your accounts.

Shipping Savings… Dr Comfort offers the following tips to help reduce your shipping costs:
You may request that your orders be collected, combined, and shipped together once per week/month. Simply contact us to let us know you would like this set up at 1-800-556-5572.
Submit all your orders at one time; all orders submitted the same day will ship together.
Bundle your Biofoam impressions together to ensure they are entered at the same time. UPS will allow you to use a single return label for the entire bundle.

As the shoe drops.... Deep into summer and kids are out of school -what a great time to seek out the young feet. Many of the parents, grandparents and great grandparents who are my patients have great influence on their kids. With this is mind, I set out to harvest some young feet during the summer. One idea is to add a flyer in your monthly statement saying that children's feet should be examined at least yearly, as many problems we see in adult feet can often be easily prevented as children. I also suggest you contact the local day camp and park programs, as many kids often hurt their feet. Let the programs know that you accept emergencies and can often by-pass the long emergency room waits. Often when this happens you get a completely new patient, and between the new child and the parents and aunts and uncles and grandparents you have just increased your practice by a few new clients. While in my office, the adults notice my highly visible Dr. Comfort stands and I often sell a pair of shoes to them. Remember you can sell the shoes to non-diabetics (at same cost as Medicare charges). Keeping people enjoying life, and thinking about their feet -that's good for Podiatry. -
Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the shoe drops.... I just wanted to thank all of you that have contacted me about the value of this column, it is appreciated and I am thankful to Dr. Comfort for this opportunity to share my thoughts with you. Summer is a bit of a slower time in my office and gives me time to evaluate how my practice patterns compare to the "bench-marks". For example -upon review of the newest B-MED (Medicare billing records) data for 2005, I noticed that while Podiatrists billed heat molded insoles almost twice as often as custom insoles (851,000 v. 443,000), the use of custom insoles was significant. This is interesting to me because my practice’s use of custom insoles was much lower than the national averages. That got me to stop and think -am I performing a disservice to my patients by not using more custom insoles? Based on this, I am going to re-evaluate my prescribing pattern and prescribe the insole that is best for each individual patient. This will keep me on my goal of providing the finest care available, and "that's good for Podiatry" -Bret M. Ribotsky, DPM, FACFAS, FACFAOM Medical Director for Dr. Comfort

As the Shoe Drops… The 2,000 doctors who joined me at the APMA annual meeting this past week certainly got a solid helping of new procedures, new products, office efficiency and office management. What I learned in the lecture halls was great, but some of the stuff that I learned in the hallways and at meals with my colleagues was even better. Now that this information is fresh in your mind, the key to making a successful change in your practice is to act on what you have learned – and do it quickly. Don’t wait.
So why don’t we get together more often on a local level to keep these (and other) ideas fresh and real? These informal meetings with colleagues can only serve to improve your practice. Ask each other questions on staffing, dispensing and, of course, how they plan to increase the number of Dr. Comfort shoes they sell! I have been doing this for years – once we get past the griping about how little we get paid, I always come away with a new and better idea. Learning each day and practicing smarter is “Good for Podiatry”.
-Bret M. Ribotsky, DPM, FACFAS, FACFAOM

FYI… To maintain display stability, please check that the center bolt and nut holding the base together has not been loosened by patients turning the top portion of the display.
Marketing Updates… In an effort to enhance the partnership between Dr. Comfort and our customers, we will now be offering stickers featuring your office address and contact information to personalize catalogs mailed to your office. Accounts who have already personalized their catalogs have shown an average of a 20% increase in sales and a 15% increase in patient population.
These benefits occur based on the following: First, existing patients show the catalog to their friends and family, which brings in referrals. Second, customers utilizing this practice show a very high annual Medicare patient retention rate in comparison to competitors’ brands. In fact, customers have told us that patients choose their offices for their foot care needs over others based solely on the availability of the Dr. Comfort brand. In addition, many patients who receive shoes through the Therapeutic Shoe Program are so satisfied that they purchase additional pairs outside of the program within the same year. Catalogs will remain a complimentary marketing aid, and are available by request via phone (1-800-556-5572), the web at www.drcomfortdpm.com or fax (262-242--5300).

Marketing Updates… As part of our continuing commitment to increase your patient growth and corresponding sales, Dr. Comfort now personalizes all our catalogs sent with your shoe orders. As of this fax, we are applying labels that contain your office’s contact information to the back of the catalogs before the shoes are shipped.
This label will give your patients an easy reference to your office for additional shoe orders. In addition, we are told that many patients share their catalog with friends and family-a sure-fire way to grow your patient population.
There will continue to be NO CHARGE for this service-just another example of our striving to provide you with superior customer service and support.

To better serve you… In order to expedite your Accounts Receivable questions, please use the following direct numbers:
For Patty Leonardelli 262-236-8479 For Jean Puls 262-236-8471

Order Tips… We have noticed a recent spike in the number of returns due to order duplication. To help alleviate this, we offer the following tips:
When faxing or calling in orders, it is important to wait at least 24 hours to receive confirmation by fax that your order has been processed. If you have not received order confirmation within 48 hours, please contact our office to verify order receipt before refaxing the order or calling it in again.
When dealing with custom inserts, please do not fax anything unless specifically requested to do so. Include the Custom Insert Return form with your return order to let us know of any adjustments or reorders.

As the shoe drops... Welcome to the first edition of a regular column in the Dr. Comfort Updates. My goal is to share what I’ve learned and to educate all of Dr. Comfort's customers on how to excel in the Therapeutic Diabetic Shoe Program within their practice. Due to limited space in this column, tips are going to be quick and to the point.
Now that January is over, it is time to schedule a visit with your Diabetic patients to whom you dispensed shoes already this year. Following up within a month of the dispensing visit is a very good way to check that the shoes are being worn and the insoles are working. Keeping diabetic patients in their protective shoes saves feet, and that's good Podiatry! -Bret Ribotsky, DPM, FACFAS, FACFAOMA Medical Director for Dr. Comfort