NEMT Arizona

NEMT in Arizona is a crucial service for thousands of individuals who need medical assistance

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NEMT Arizona

NEMT (Non-Emergency Medical Transportation) is a service that offers accessible and efficient healthcare transportation for those who aren't in an emergency but need greater assistance than a taxi will normally provide. NEMT Arizona is a crucial service for thousands of individuals who need medical assistance. Non-emergency medical transportation in Phoenix, Arizona may help people in the following situations:

  • Traveling to and from Doctor Appointments
  • Getting to Outpatient Surgeries
  • Getting to Post-Surgery Check-ups
  • Transportation for Therapy Appointments

In recent years, the size of NEMT in Arizona has been expanding to include more providers to meet the growing needs of people across the state. The Arizona Health Care Cost Containment System (AHCCCS) merged with the Arizona Department of Health Services and the Division of Behavioral Health Services in 2016. AHCCCS now administers NEMT benefits for behavioral health and physical health services. Providing NEMT services in Arizona will include the following steps:

  • Secure Funding: There are both private and government funding available. Primary expenditures would include purchasing vehicles, equipping vehicles, providing driver training, obtaining insurance and permits, and any marketing for a NEMT business in Arizona. 
  • Complete All Legal Steps: This includes forming a legal business structure and securing Employee Identification Numbers (EIN).
  • Secure Certifications: Besides certifications for a NEMT Arizona business, there are licenses and permits to obtain.
  • Purchase Transport Equipment: This includes vehicles as well as several features and specialized equipment. This might include first aid kits, wheelchair ramps, and full-service software solutions to optimize routes and driver schedules. 
  • Purchase Insurance: Insurance is a crucial aspect of transporting individuals. There are different types of insurance to consider, such as general liability insurance, commercial auto insurance, and workers' compensation.
  • Hire Employees: Depending on the size of a NEMT Arizona business, a provider may need to hire dispatchers, managers, and accountants besides drivers.

The following information will provide more detailed information on how to start a non-emergency medical transportation business in Arizona, what to know regarding an Arizona NEMT transportation provider enrollment application, and what is included in the certification process.

Non-Emergency Medical Transportation

Patient wellness includes preventative care, outpatient surgical care, and chronic care management. Non-emergency medical transportation (NEMT) services are often a crucial aspect of providing the best patient wellness care possible. 

An emergency is defined as an event or circumstance that puts the life or health of an individual at great risk without immediate medical treatment. NEMT transportation is normally intended for doctor and therapy appointments or other types of non-emergency care. 

Many people face transportation barriers that can hinder timely and adequate healthcare. NEMT is crucial to ensuring patients have access to all their healthcare needs. NEMT primarily serves individuals with barriers to reliable transportation. Barriers might include not having access to a reliable vehicle, not having a valid driver's license, or having developmental, physical, or mental limitations. 

Many individuals with healthcare needs face barriers to reliable transportation and receive Medicaid benefits. Transportation was established as a required Medicaid benefit in 1966. NEMT transportation options might include buses, taxis, stretcher cars, and wheelchair vans. An NEMT provider should provide the following basics regarding transportation:

  • Drivers should provide reliable and adequate transportation to and from each appointment. 
  • Drivers should also offer the most appropriate form of transportation. 
  • Drivers should take the safest and most efficient route.

Transportation is part of each patient's treatment plan. Poor, inadequate, or delayed transportation can negatively impact health outcomes. Millions of individuals don't receive medical treatment because they don't have access to reliable transportation. 

The AHA reports transportation problems are the third leading cause of missed medical appointments. Without adequate transportation, healthcare costs can increase while positive individual health outcomes can decrease.

NEMT Certification

Whether it's a non-emergency medical transportation license, NEMT certification, or another type of permit or registration, it's important to know about the different certifications and regulations NEMT brokers must comply with to operate legally in Arizona. Besides the legal certifications that are essential for businesses to operate, there are also certifications and programs for individual drivers.

Local and state healthcare services and each state's Department of Motor Vehicles will have various requirements to obtain and maintain for the NEMT Certification and registration process. The following information lists various certifications, licenses, and permits businesses may need to operate a NEMT business. These apply to the state of Arizona.

  • AHCCCS NEMT Training Certification
  • Vehicle Registration for All Vehicles Used by the Business or Individuals
  • Vehicle Insurance
  • Signed and Dated Provider 28 Profile Form
  • ADOT Vehicle Hire Permit
  • A Vehicle Logo for Identification
  • Tribal Business License if Providing Services for Arizona Tribal Reservations

Passenger Assistance Safety and Sensitivity Trainer and Driver Certification (PASS) is another type of NEMT Certification that those operating a non-emergency transport business may want to obtain. Arizona NEMT brokers and providers will want to familiarize themselves with this program.

  • The PASS program teaches drivers the necessary skills for transporting different types of passengers safely and efficiently.
  • This three-day program teaches assistance techniques and sensitivity skills so all passengers, including those with disabilities, receive safe and effective transportation.
  • After finishing the program, PASS Certification is active for three years. Individuals can renew their certification by participating in another PASS program or an online workshop.

List of Funding Sources

The list of non-emergency medical transportation companies is extensive. There are also various funding sources for each provider. AHCCCS emergency transportation and AHCCCS medical transportation may receive funding from the following sources:

  • Financial and Insurance Institutions: Providers starting a non-emergency medical transportation business might seek loans from traditional lending sources, such as banks. Private insurance companies also sometimes provide coverage for individuals needing this type of transportation service.
  • Business Grants: There are several grant providers that businesses can apply for. These include Accelerating Innovative Mobility (AIM), Federal Transit Administration(FTA), which is part of Notice of Funding Opportunity (NOFO) Grants, American Rescue Plan (ARP) Grants, Rural Business Development Grants, and Retired and Senior Volunteer Program Grants.
  • Government Agencies: Medicaid will often cover the cost of non-emergency transportation for eligible individuals. Medicaid NEMT benefits receive authorization under the Social Security Act. The Veteran Affairs (VA) also sometimes provides non-emergency transportation services. The Arizona Health Care Cost Containment System (AHCCCS) will cover ground and air transportation for non-emergency, medically necessary healthcare.

The following are a few points providers and brokers should know regarding funding and billing procedures.

  • While AHCCCS will cover most non-emergency medical-related transportation, non-emergency transportation isn't covered for FES (Federal Emergency Services) members.
  • Providers need to bill the number of miles as units of service and the number of trips on the CMS 1500 claim form. Brokers and providers should measure mileage in statute miles. This is the distance traveled while a recipient is in the vehicle and transported to a medically necessary service.

NEMT Provider Application

An individual or business may wonder how to become a transportation provider in Arizona. The process starts by filling out a NEMT provider application. The following are the steps when preparing a non-emergency medical transportation application.

Begin the preparation process by including the following documentation:

  • Obtain an NPI Number:  A company will want to obtain this 10-digit number from the National Plan and Provider Enumeration System (NPPES).
  • Provide Professional Licensures and Certifications: A provider must maintain licenses and certifications in their professional field. The Arizona Department of Health Services can help answer questions.
  • Complete Tax Forms: Providers receiving federal or state funds for serving Medicaid recipients need to complete a W9 tax form. These forms are found on the IRS website.

General Provider Requirements for non-emergency medical transportation application:

  • Screening Each Provider's Risk Level: A provider is screened according to their assigned risk level. Risk levels are limited, moderate, and high.
  • Provide Application Fees: The government requires a fee for medical items and services. The fee is to offset costs for required screening. The 2023 fee is $688.
  • Required Data Fields: Applicants will need to provide their home address, email address, hours of operation, languages spoken, if they are handicap accessible, and a taxonomy number that defines a provider's area. 

The time frame for processing the application is approximately 60 days. When filling out a non-emergency medical transportation provider application, the provider may request an expedited application.

Contact MediRoutes

MediRoutes is software for the Non-Emergency Medical Transportation (NEMT) market that enables businesses to become more efficient and offer excellent service to the public. This easy-to-use and affordable software provides excellent support and customer-driven innovation.

Primary features include the following:

  • Real-Time Dispatching
  • Optimized Scheduling, Billing, and Reporting
  • Optimized Data Integration
  • 24/7 Support
  • Cloud Service
  • Broker Integrations

NEMT is a business that is growing across the country. As the elderly population continues to increase, there will be a greater need for reliable medical transportation. MediRoutes provides the latest technology for both brokers and transportation providers. Contact us today for more information.

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