Free OpenClaw Skill for Podiatry Clinics: Diabetic Foot Recall and DME Agent (Download)

What this skill does for your podiatry clinics

• Builds the diabetic foot exam recall list every Monday from ModMed EMA Podiatry or athenaPractice, with high-risk (Medicare LOPS-qualified) patients prioritized.
• Owns the routine foot care recall (debridement, nail care) for the Medicare-covered 61-day cycle with Q-modifier documentation reminders for the front desk.
• Runs the DME custom insert pipeline: casting appointment to fabrication to dispense to follow-up, billed under HCPCS A5513 for inserts and L4361 for the diabetic shoe.
• Surfaces the Medicare LCD documentation checklist before claim submission so the practice does not get denied on diabetic shoe coverage criteria.
• Routes every patient-facing message through the office manager or DME coordinator for approval by default; flips to autonomous after a two-week validation on rails you define.

What's inside this OpenClaw skill

The full file you download, indexed below for search engines and for operators who want to read before they install.

---
name: podiatry-recall-and-dme
description: Diabetic foot recall and DME billing coordinator for podiatry clinics. Quarterly diabetic foot exam, Medicare 61-day routine foot care cycle, DME custom inserts billed under A5513, diabetic shoes L4361, Medicare LCD documentation. Integrates with ModMed EMA Podiatry, athenaPractice.
version: 1.0.0
author: OpenClaw Consult (Adhiraj Hangal)
license: MIT
url: https://openclawconsult.com/skills/podiatry-clinics
---

# OpenClaw Skill: Podiatry Recall and DME Billing Coordinator

## Overview

This skill turns the OpenClaw agent into a recall and DME pipeline coordinator
for a podiatry clinic. It owns the diabetic foot exam recall, the Medicare
61-day routine foot care cycle with Q-modifier documentation, the DME custom
insert pipeline (HCPCS A5513) and the diabetic shoe pipeline (HCPCS L4361),
and the Medicare LCD documentation checklist that decides whether the claim
gets paid.

It is designed for 1 to 4 podiatrist practices running ModMed EMA Podiatry,
athenaPractice (athenahealth), eClinicalWorks, or SammyEHR. Both single-site
clinics and small multi-location DPM groups work.

## What this skill does

1. Quarterly diabetic foot exam recall with high-risk LOPS-qualified patients prioritized
2. Medicare 61-day routine foot care cycle with Q-modifier (Q7, Q8, Q9) documentation reminders
3. DME custom insert pipeline: casting to fabrication to dispense to follow-up, billed under A5513
4. Diabetic shoe pipeline billed under L4361 with full LCD documentation tracking
5. Ingrown and minor procedure follow-up at 7 and 14 days
6. Wound care and ulcer recall for patients in a healing pathway

## Triggers

```yaml
triggers:
  - type: heartbeat
    schedule: "0 7 * * 1"          # Mondays 7am
    action: compile_diabetic_foot_recall

  - type: heartbeat
    schedule: "0 8 * * 1"          # Mondays 8am
    action: routine_foot_care_61day_cycle_pass

  - type: heartbeat
    schedule: "0 9 * * 3"          # Wednesdays 9am
    action: dme_pipeline_status

  - type: on_event
    event: pms.dme_order_created
    action: enter_dme_pipeline

  - type: on_event
    event: pms.diabetic_shoe_prescribed
    action: build_lcd_documentation_checklist

  - type: on_event
    event: pms.routine_foot_care_completed
    action: schedule_next_61day_recall
```

## Workflow: diabetic foot recall

Every Monday at 7am the agent:

1. Pulls all active diabetic patients from the PMS
2. For each, looks up the last comprehensive foot exam date
3. Flags any patient over 90 days since last exam
4. Stratifies by risk: LOPS positive, deformity, prior ulcer or amputation, peripheral arterial disease
5. Prioritizes the high-risk subset for the next week's schedule
6. Drafts personalized recall texts that name "your foot check with Dr. {provider}"
7. Routes drafts to the office manager for approval

A representative practice with 1,200 active patients has 250 to 400 diabetic patients on the panel. The skill triages the 50 to 90 due each week into a manageable Monday roster.

## Workflow: Medicare 61-day routine foot care

Medicare covers routine foot care (nail debridement, callus removal, etc.) once every 61 days for patients with a qualifying systemic condition and documented Q-modifier basis. After a routine foot care visit logs, the skill:

1. Stamps the 61-day next-eligible date in the recall ledger
2. Schedules the recall outreach for the day before eligibility opens
3. Drafts the parent-friendly recall message inviting the patient to book
4. Attaches a front-desk note reminding which Q modifier the chart supports (Q7 one Class A finding, Q8 two Class B findings, Q9 one Class B and two Class C findings)

The Q-modifier reminder is the kind of detail that decides whether the claim pays.

## Workflow: DME custom insert and diabetic shoe pipeline

A custom insert (A5513) or diabetic shoe (L4361) order has a pipeline:

1. Order created in PMS
2. Casting appointment booked (the skill drafts the booking message)
3. Lab fabrication sent to the supplier (1-3 weeks)
4. Dispense appointment booked when lab confirms shipment (the skill drafts that booking too)
5. Dispense completed
6. Follow-up at 30 days for fit check
7. Annual reorder cycle for diabetic shoe + 3 pairs of inserts per Medicare coverage

The skill maintains a pipeline view so the DME coordinator can see exactly which orders are stuck where on a given Wednesday morning. For the diabetic shoe (L4361) the skill maintains the LCD documentation checklist:

- Certifying physician statement of diabetes
- HbA1c within 6 months
- Foot exam findings documenting at least one qualifying condition (calluses, deformity, neuropathy with callus formation, poor circulation, prior amputation, prior ulcer, history of pre-ulcerative callus)
- Detailed written order signed by the prescribing physician

Missing elements are surfaced before claim submission, so the practice does not eat the denial.

## Message templates

```yaml
templates:
  diabetic_foot_recall_high_risk:
    body: |
      Hi {patient_first_name},

      It is time for your quarterly foot check with Dr. {provider_last_name}.
      Given your medical history we want to make sure we are keeping a close
      eye on things. It is a quick visit, just the foot exam, usually
      covered in full by your insurance.

      Open slots:
      {open_slots}

      Reply with what works.

      {office_manager_first_name}

  routine_foot_care_61day:
    body: |
      Hi {patient_first_name},

      Time for your next foot care visit with Dr. {provider_last_name}.
      Medicare covers this every 61 days, and you are eligible again
      starting {next_eligible_date}.

      Open slots:
      {open_slots}

      {office_manager_first_name}

  dme_casting_appointment_scheduled:
    body: |
      Hi {patient_first_name},

      Your casting appointment for the custom inserts is scheduled for
      {casting_date} at {casting_time}. The casting itself takes about 15
      minutes. After that the lab will fabricate the inserts (usually 2 to 3
      weeks) and we will text you when they are ready for dispense.

      {dme_coordinator_first_name}

  dme_inserts_ready_for_dispense:
    body: |
      Hi {patient_first_name},

      Good news, your custom inserts are back from the lab. We will need
      about 30 minutes for the dispense visit so Dr. {provider_last_name}
      can check the fit and walk through the break-in period.

      Open slots:
      {open_slots}

      {dme_coordinator_first_name}

  diabetic_shoe_lcd_documentation_gap:
    channel: internal_slack
    body: |
      LCD DOCUMENTATION GAP
      Patient: {patient_first_name} {patient_last_name}
      Order: L4361 diabetic shoe + A5513 inserts
      Missing: {missing_lcd_elements}
      Action: chase {responsible_party} before claim submission
      Order link: {order_url}
```

## Memory keys

```yaml
memory:
  - key: pod.diabetic_foot_recall[{patient_id}]
    description: Quarterly comprehensive foot exam ledger
    schema: { last_exam: date, next_due: date, risk_stratum: string, lops_status: string }

  - key: pod.routine_foot_care_61day[{patient_id}]
    description: Medicare 61-day cycle state
    schema: { last_rfc_date: date, next_eligible: date, q_modifier_basis: string }

  - key: pod.dme_pipeline[{order_id}]
    description: Custom insert or diabetic shoe pipeline stage
    values: [order_created, casting_scheduled, casting_done, lab_pending, ready_for_dispense, dispensed, follow_up_30d, complete]

  - key: pod.lcd_checklist[{order_id}]
    description: Medicare LCD documentation status for L4361 / A5513
    schema: { phys_diabetes_statement: bool, hba1c_within_6mo: bool, foot_exam_findings: array, written_order_signed: bool }
```

## Required integrations

| Integration              | Purpose                                          | Read | Write |
|--------------------------|--------------------------------------------------|------|-------|
| ModMed EMA Podiatry      | FHIR API for visits, DME orders, risk fields     | yes  | optional |
| athenaPractice           | REST API and athenaCommunicator hooks            | yes  | optional |
| eClinicalWorks           | eBO reports and ECW API                          | yes  | optional |
| DME supplier portal      | Order status updates                             | yes  | no    |
| Twilio (or similar)      | Outbound SMS                                     | no   | yes   |
| Email provider           | Outbound email                                   | no   | yes   |
| OpenClaw Memory          | Cross-run state                                  | yes  | yes   |
| OpenClaw Heartbeat       | Scheduled cadence triggers                       | yes  | yes   |

Write-back to the PMS starts disabled. The office manager commits any PMS changes manually for the first two weeks. After validation, flip on write access for low-risk fields (recall date stamps, communication log entries, DME pipeline stage stamps).

## Compliance notes

HIPAA: by default the skill operates on patient identifiers, appointment dates, and DME order metadata. Clinical findings (HbA1c values, ulcer staging, neuropathy testing) are not put into outbound SMS. For practices that want tighter PHI handling, set phi_mode to identifier_only.

Medicare LCD compliance: the skill mirrors the documentation checklist for L4361 diabetic shoe coverage but does not submit the claim. The biller remains responsible for the actual claim submission. The skill exists to make sure the documentation is complete before the claim goes out.

Q-modifier documentation for routine foot care is surfaced as a front-desk reminder, not asserted on the claim. The provider remains responsible for documenting the qualifying systemic condition and the Class A, B, or C findings that support the modifier.

Confirm your BAA covers the cloud AI provider you point OpenClaw at.

## Configuration

```yaml
config:
  practice_name: "Your Podiatry Clinic"
  providers:
    - last_name: "Vasquez"
      open_slot_lookup: ema_calendar
  approval_mode: office_manager_approves_all   # or "autonomous_after_2_weeks"
  phi_mode: standard                           # or "identifier_only"
  recall_cadences:
    diabetic_foot_exam: quarterly
    routine_foot_care_medicare: 61_days
  dme_pipeline:
    lab_default_turnaround_days: 21
    dispense_followup_days: 30
    diabetic_shoe_annual_reorder: true
  medicare_mac: "Noridian JF"
  lcd_documentation_required:
    - physician_diabetes_statement
    - hba1c_within_6_months
    - foot_exam_qualifying_finding
    - signed_detailed_written_order
```

## Quick install

```bash
mkdir -p ~/.claude/skills
mv podiatry-clinics.md ~/.claude/skills/podiatry-recall-and-dme.md
# Edit the config block to match your clinic
```

Launch OpenClaw and the skill is live. Run `compile diabetic foot recall` or `dme pipeline status` on demand, or wait for Heartbeat to fire on the configured schedule.

## Want it wired to your stack?

This SKILL.md is the starting point. If you want it plugged into your specific PMS, your MAC's LCD specifics, your DME supplier integrations, and your specific brand voice, on a fixed-price two-week clock with the founder writing every line of the build, the door is at
https://www.adhirajhangal.com/work

Install in 60 seconds

1. 1

   Drop the file into your OpenClaw skills directory

   Save the downloaded podiatry-clinics.md as ~/.claude/skills/podiatry-recall-and-dme.md (or your project-level .claude/skills/). OpenClaw picks up new skill files on next agent launch.

2. 2

   Connect your practice management system

   Edit the integrations block to point at your ModMed EMA Podiatry or athenaPractice export. Read-only access is enough to start. The skill ships the prompts that translate your daily PM export plus the diabetic foot risk stratification field into the agent's working memory.

3. 3

   Launch in approval mode, validate, then flip to autonomous

   Start with the office manager approving every outbound text and email for the first two weeks. Defaults route anything that touches an ulcer, a referral, or DME documentation to a human. After two weeks of validation, flip the routine recall and DME logistics templates to autonomous.

Example conversation

Common questions

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