What Is NEMT?

Non-emergency medical transportation (NEMT) caters to people who require medical care but cannot get around due to debilitating medical conditions or lack of transport. Patients who benefit from this service don't require emergency care. They need it to get to and from rehabilitation facilities, doctor's appointments, and other healthcare services like dialysis, chemotherapy, and physical therapy.

NEMT transportation vehicles are outfitted with a wheelchair ramp or lift, handrails, ergonomic seats, and other modifications designed to make for an easy and comfortable journey for passengers with medical needs. Non-emergency medical transportation requirements may also include special equipment like stretchers, walkers, oxygen tanks, GPS tracking devices, and first-aid kits.

Role of Non-Emergency Medical Transportation in the Healthcare Industry

NEMT providers play a crucial role in addressing health disparities in a country like the United States, where several factors affect access to healthcare. Here are some ways that NEMT providers can help address this problem:

Overcome Transportation Barriers

Individuals with disabilities and seniors often have difficulty getting to their scheduled medical appointments due to the lack of transportation. Mobility issues make it difficult for them to use traditional modes of transport. Thus, NEMT providers play a critical role in bridging this gap to ensure that people who need access to healthcare have safe, affordable, and convenient transportation to get to their medical appointments on time.

Help Reduce Healthcare Cost

Lack of transportation often leads to missed doctor's appointments, regular treatments, and other critical healthcare services. This barrier to transport could aggravate medical conditions, resulting in emergency room visits and hospitalization. NEMT providers offer timely access to essential healthcare services to reduce hospitalization risk, thereby improving health outcomes and reducing healthcare costs.

Promote Health Equity

Lack of transport is one of the social determinants of health. People in low-income homes and those in rural areas, miles away from the nearest healthcare facility, will find it harder to access critical resources. NEMT addresses this issue and promotes health equity in the process.

NEMT Transportation

With NEMT providers playing a vital role in providing equal healthcare access, the question that often comes to mind is: who pays for non-emergency medical transportation?

Medicaid

Medicaid covers the bill of most NEMT passengers. This State- and federal-funded insurance covers the healthcare costs of people with disabilities and low-income individuals. However, it's important to note that Medicaid only covers NEMT rides to and from healthcare facilities, doctor's clinics, and hospitals.  

Eligibility for Medicaid NEMT coverage varies by State. Generally, beneficiaries must meet the following requirements:

• Patients must be enrolled in the Medicaid program.
• Patients must prove that they have unmet transportation needs for medical purposes.
• They must meet asset and income limits.
• They must have a qualifying medical condition that warrants NEMT transportation. 
• Some states require that patients call in to schedule a pre-approved NEMT service. In California, for example, patients must call Partnership Transportation Services to schedule a doctor-approved NEMT service at least five days before the appointment.

Private Pay

Individuals not eligible for Medicaid coverage can pay for the service out of their pocket. The upside of this option is that private pay passengers have more flexibility in terms of NEMT service. For instance, they can request an NEMT provider to take them to the gym.

Billing for private pay customers is also very straightforward. As soon as the NEMT provider delivers the service, they can send an invoice to their clients. Then, clients pay for the service through their payment method of choice. Payment methods include cash, credit cards, PayPal, debit cards, and/or checks.

Non-Emergency Medical Transportation Services

To learn how to become a NEMT transportation provider, you must first determine what type of NEMT service you'll offer. Common types of non-emergency medical transportation services include:

Ambulatory Transportation

The most common type of medical appointment transportation service, ambulatory transportation, is for people who can walk independently and don't use special medical equipment when they travel. Customized sedans with spacious passenger seats can be used for this type of NEMT service.

Wheelchair Transportation

This NEMT service is specifically for people who use wheelchairs. To offer this type of service, larger vans outfitted with ADA-compliant wheelchair ramps or lifts are required. Drivers are trained to perform CPR and other life-saving drills for this service.  

Stretcher Transportation

This option is for bedridden individuals. These patients must be transported to their medical appointments using stretchers. Since it is very challenging for one person to handle a patient on a stretcher, drivers often have assistants with this type of service.

Medical Courier Service

NEMT providers can also offer their services as medical couriers. With this service, NEMT providers will transport blood and human organs from one medical facility to another. Sometimes, private pay clients may also book a medical courier to deliver medical devices, oxygen tanks, and other medical equipment they need at home.

How to Become an NEMT Provider for Medicaid

Requirements to become a NEMT provider for Medicaid vary for different states. Before starting a non-emergency medical transportation application, providers must know the State's licensing requirements for drivers and vehicles.

However, regardless of which State you're going to submit your non-emergency medical transportation provider application, you need to complete the Medical Transportation Provider Application Package. This package includes:

• Vehicle registration
• Vehicle insurance
• Driver's license
• Other documents

It's important to note that some states contract third-party transportation brokers to manage preauthorized services in a specific area. Transportation brokers will have to submit bids to assume this responsibility on behalf of the State. 

How to Get Private Pay Clients

While it's quite expected that Medicaid beneficiaries will be the majority of most NEMT provider's clientele, they shouldn't be the sole focus of your business. In many ways, having private pay clients presents many advantages over Medicaid clients.  

For starters, you receive payments immediately with private pay clients without hidden fees. Unlike most insurance companies, you won't have to wait weeks or months to get paid for services rendered.  

Another advantage is that you can set your rate with private pay clients. Thus, you're expected to have higher margins than insurance-covered trips. Plus, you won't have to adhere to collection procedures and regulations that insurance companies impose on NEMT providers.  

Marketing is the most important to focus on if you want private pay clients. Since you won't have brokers to pass clients to you, you must ensure you're prepared to market the business yourself. Cultivating a robust online presence, using paid advertising strategies, and optimizing your website for the search engines are some ways to ensure clients find your business.  

NEMT Certification

There is no national standard for NEMT certification. Each State has its specific requirements. However, there are standard guidelines that NEMT providers need to consider:

NEMT Driver Requirements

Typically, basic requirements include a valid driver's license and a background check. Ideally, however, NEMT operators must also have a stringent NEMT driver training and evaluation process. Since NEMT drivers are responsible for transporting people with varied medical needs, brokers and operators must ensure they are up to the task. NEMT drivers may undertake first-aid and CPR, wheelchair transport training, and vehicle maintenance before they can have a non-emergency medical transportation license from some States.

NEMT Vehicle Requirements

Before getting a non-emergency medical certification, the State typically ensures that the NEMT vehicle is safe and ADA-compliant. As a NEMT provider, you must go the extra mile to ensure that the vehicles undergo regular inspection and maintenance of brakes, motors, lights, tires, and other parts of the vehicle.   

NEMTAC Certification

The Non-emergency Medical Transportation Accreditation Transportation (NEMTAC) is one of the most widely recognized national organizations that provides NEMT certification. To be accredited, NEMT providers must secure the following requirements:

• Business License: A valid business license is necessary, and the business must adhere to all state and local laws.
• National Provider Identifier: This is a unique identifier for all healthcare personnel. You can obtain this ID number from the Centers for Medicare & Medicaid Services (CMS).
• Employer ID Number: Business entities can obtain this online from the Internal Revenue Service website. This is also widely known as the Federal Tax Identification Number.
• Relevant NEMT Services: The business must offer relevant NEMT services such as wheelchairs, stretchers, and paratransit services.

Non-Emergency Medical Transportation Cost

In terms of medical transport cost per mile, non-emergency medical transportation cost is way more affordable than that of an ambulance. So, how much does emergency medical transportation cost? Here are the two most important factors that influence that number:

Distance of the Trip

Simply put, a trip across the country would cost more than a trip within the city. So the next time someone asks, "How much does long-distance transport cost?" The most accurate answer would be — it depends on the mileage.

Specialized Personnel Needed

Another determinant of the transport cost is the number of medical professionals on site. One driver may be enough to assist an ambulatory patient. However, patients with mobility issues may need the services of more than one medical professional. Trained professionals are needed to handle the stretcher or wheelchair to prevent injury to the patient, so these services cost more.

NEMT is a growing industry that meets the real-world needs of patients with no other means of vital access to healthcare. By providing safe and reliable transport service, coupled with robust software that takes care of the scheduling, dispatching, and billing, NEMT providers are set to succeed in this flourishing industry.