NEMT programs are becoming increasingly important for those dealing with chronic conditions. These include heart disease, arthritis, diabetes, obstructive pulmonary disease, and cancer. As a result, they are driving an increasing number of Medicaid enrollments and resulting in greater demand for NEMT services.
The Medicaid program is expanding in many states, with projections indicating that more than 9 million people will be added to the program by 2020. There are already more than six million people enrolled in CHIP and Medicaid as of April 30, 2014. The new population will have fewer needs for NEMT services, but it will still strain some systems.
To become an effective NEMT operator, you must first build relationships with insurance providers. The guidelines and policies of each insurer differ, so it’s important to check with them to determine the best options. Next, you must market your service to potential clients, including caregivers and families. This requires a mix of traditional and digital marketing. Be sure to reach a variety of audiences and use a proven marketing ROI tracking strategy.
As an NEMT provider, your legal structure matters, especially if you plan to partner with a payment provider or a health insurance provider. Regardless of the legal structure of your non-emergency medical transportation business, you must be aware of the tax implications associated with the business. Depending on the legal structure you choose, you may want to incorporate as a sole proprietorship, partnership, or LLC. An attorney will be able to explain the benefits and disadvantages of each type of entity.
A good business plan is essential for a successful NEMT startup. Not only does it improve the overall efficiency of the business, but it also helps you to maximize your revenue. The use of non-emergency medical transportation software can also help you track payments and collect compliance data, which is important for your business. It can also increase your efficiency by 20 percent to 40 percent, making your business more profitable.
Non-emergency medical transportation is vital for many Medicaid recipients. People with limited mobility are often unable to get around or are unable to afford a vehicle. However, many of them cannot access traditional public transportation. In fact, it’s estimated that between 2015 and 2018, 32 states reported more than 59 million Medicaid NEMT trips for preventative, behavioral, and dialysis care. Furthermore, delays in receiving care cost the health care system an additional $150 billion dollars each year.
State-administered NEMT programs must verify the member’s eligibility for these services. Once a member is approved for a service, he or she has 60 business days to contact a medical review agent. This medical review agent will review the LOS assessment and determine the appropriate level of service. In many cases, state-administered NEMT transport services will be approved for a span of days, weeks, months, or even years. In order to maintain compliance, a member must also record and report all necessary information.