Participants and Billing
You must put at least 1 participant through your program within the first 6 months after accreditation and every year thereafter, whether you are able to bill for them or not.
As a member of ADCES, you have access to the Ask the Reimbursement Expert. Also, make sure you are asking your billing specialists about any denials of claims for your diabetes education codes (G0108 individual/G0109 group); you may be able to appeal those denials and learn what to do to submit correctly to be reimbursed moving forward.
You cannot go more than 30 days without a designated Quality Coordinator; interim coordinators still need to meet continuing education requirements. You must report a change in coordinator to ADCES within 30 days of the change. Find information about submitting a change of status.
You will need to keep a record of all of your team’s continuing education, certificates, registrations and licenses annually. You will be asked to attest that your team has kept up their required CE’s, so it’s a good idea to create a tracking form. For those without a CDE or BC-ADM certificate, the requirement is 15 hours annually. Those with certification need to meet their certification requirement to maintain a current certificate, but do not have to report annual hours to ADCES.
Changes of Status
You need to notify ADCES of any major changes in your program within 30 days of the change. One example would be adding new sites. Find information about adding a site.
Data and Reporting
Make sure you are collecting the required data to report to your stakeholders at your 6 month meeting and to submit on your Annual Status Report (ASR) This includes a minimum of behavioral goal aggregate data, clinical outcomes aggregate data and CQI project results/data to date.
Make sure you have data to submit for your Annual Status report by the due date. In years 1-3 of accreditation, you can submit 30 days before or up to 30 days after your accreditation date (date on your certificate). In year 4, you must submit your ASR at least 30 days before your accreditation expiration date and then proceed with submitting a reaccreditation application. Your ASR is considered late if not submitted at least one week before your expiration date. You may request an extension by emailing firstname.lastname@example.org. Find information about your annual status report.
Find information about your re-accreditation application
Your curriculum and community resource list should be reviewed and updated annually. Your stakeholders can help you identify areas that need updating and suggest new community resources to add to your list for ongoing support.
You may want to review DEAP policies annually so you are up to date, as they may occasionally change. These are policies that outline how ADCES implements procedures that may affect your status, so you want to be familiar with them.
The Compliance Policy states the procedure for program audits. You should be audit ready at all times. Set up two 3-ring binders with tabs for each standard with all supporting documents; one for a Medicare audit that has all of your original application or re-accreditation documents to send in case of a “desktop audit”and one for an onsite ADCES audit updated with current licenses, meeting minutes, CE certificates, etc.
ADCES has a checklist for self-audit in our Interpretive Guidance as well as an Education Record/Chart self-audit tool to assist you.
Medicare requires that you display your accreditation certificate along with diabetes patient's bill of rights (Español) in the area where you are seeing your participants. If you have more than one location, you will need to make copies to have at each location.Additionally here is a questions/concerns poster (Español) you can use for your location(s) as well.
Are you a new Quality Coordinator?
You may find the information on our Interested in Learning More page and our Ready to Apply page helpful in understanding more about your role and the requirements for accreditation.