What is the NEMT fact sheet for beneficiaries?
We also discuss common fraud schemes and provide fraud and abuse prevention tips. The fact sheet for beneficiaries gives an overview of the NEMT benefit.
What is the NEMT program?
The Non-Emergency Medical Transportation (NEMT) program provides eligible members transportation needed to get to their medical appointments. To be eligible for these services, members must have no other means of transportation available and are only transported to those medical services covered under the Medicaid program.
How do I schedule transportation with NEMT?
Transportation services are provided at no cost. To schedule transportation, members must contact the NEMT Broker. Monday through Friday from 7 a.m. to 6 p.m. Logisticare 1-888-224-7981 (Central), 1-888-224-7985 (Southwest), 1-888-224-7988 (East)
How do I get a Medicare provider number?
Click here for an accurate description of how to obtain a Medicare Provider Number. Medicare provider numbers are issued by contractors who have bid and won the contract for administering the Medicare program in a specific jurisdiction. Click here for a list of Medicare contractors by state.
What is a Medicare provider number?
The article states that “A Medicare provider number is known as a “national provider identifier,” a ten-digit identification number for covered health care providers”. Obviously whoever wrote the article doesn’t understand the US Healthcare industry. Click here for an accurate description of how to obtain a Medicare Provider Number.
Do I need an NPI to enroll in Medicare?
Different provider types have varying enrollment requirements so become familiar with what your carrier needs to properly enroll you and/or your group. Yes, you must have an NPI to do business with any health insurance company including Medicare. But, your NPI is NOT your Medicare provider number.
Application Fee
Effective January 1, 2013, applicants requesting enrollment as a Medical Transportation Provider are subject to payment of an application fee upon submission of their application.
Required Documents
Gather the required documents listed below, as applicable, in order to upload them into PAVE as you complete your PAVE application.
What is the phone number for medicaid?
For example, if you have general questions about the program, you may call 800-633-4227, the Medicaid phone number. Another option is to access CMS.gov, select Contacts Database and search for a Medicaid office for a Medicaid customer service representative in your area.
How many regional offices are there for Medicare?
The Centers for Medicare & Medicaid Services has 10 regional offices in different cities and states 2. Atlanta, Chicago and New York are just a few to mention. If you want to enroll in the Medicare provider services program in person, go to the nearest regional office.
How long does it take to get approved for CMS?
Your application will be approved or declined within 45 days. Paper-based enrollment, on the other hand, takes about 60 days. If you wish to apply online, access the CMS.gov website. Before filling out your application, it's necessary to register for a national provider identifier.
Can a group practice fill out a Medicare application?
Clinics, group practices, physicians and other health care providers can fill out the Medicare enroll ment application online . This will allow them to provide services to Medicaid beneficiaries, submit fee-for-service claims and more 2. Once their application is approved, they receive a Medicaid provider number that serves as a unique identifier.
What is NEMT in medical?
The Non-Emergency Medical Transportation (NEMT) program provides eligible members transportation needed to get to their medical appointments. To be eligible for these services, members must have no other means of transportation available and are only transported to those medical services covered under the Medicaid program.
What is a NEMT broker?
NEMT Broker responsibilities include, but are not limited to: Overseeing administration and reporting. NEMT brokers are paid a monthly capitated rate based on the number of eligible Medicaid members residing in their contracted region (s). Transportation services are provided at no cost.
What is the number to call for Logisticare?
Logisticare 1-888-224-7981 (Central), 1-888-224-7985 (Southwest), 1-888-224-7988 (East) Southeastrans 1-866-388-9844 (North) and 404-209-4000 (Atlanta) If you have questions, comments, or complaints about a broker or a service, call the Member Call Center's toll free number, 1-866-211-0950.
The Basics
Medicaid transportation is a federally–required State–Plan–approved service managed and administered by the Department of Health to ensure that enrollees have access to approved medical services.
Emergency vs Non–Emergency Transportation
Emergency transportation is for the provision of initial, urgent, medical care including the treatment of trauma, burns, and respiratory, circulatory and obstetrical emergencies. Emergency transportation typically emanates from a 911 call.
Federal Requirement
The Medicaid Non–Emergency Medical Transportation benefit (NEMT) is authorized under the Social Security Act §1902 (a) (70) and 42 C.F.R.
From the County to the State
Prior to 2011 Medicaid transportation was administered by county Departments of Social Services.
How Do Enrollees Get Transportation?
The medical provider or the enrollee contacts the appropriate transportation manager to request transportation: The Department of Health´s policy requires 3 days´ notice for non–urgent trips.
Public Transportation Automated Reimbursement (PTAR)
Medical providers pre–purchase Metrocards from the Metropolitan Transportation Authority and distribute them to eligible Medicaid enrollees at the time of appointment. The medical provider submits real–time for reimbursement of the MetroCard. PTAR reimburses the medical provider $5.50/claim.
