NEMT Insurance and Billing: What You Need to Know Before Booking Transportation

The medical industry, especially as it pertains to billing and insurance, is a complicated one that can cause patients to become overwhelmed and utterly confused. Is this ride covered? Am I paying a fair amount? These are all questions that plague patients as they navigate the unknown waters of medical expenses and insurance policies. You just want to worry about being healthy. In this blog post, we’ll dive headfirst into NEMT insurance and billing questions, to ensure you feel comfortable when it comes time to pick up the phone and secure non-emergency medical transportation.

One of the main concerns surrounding NEMT is cost, and is that cost fixed? Non-emergency medical transportation cost is not fixed and varies based on a few variables, such as:

• Location
• Type of service
• Time of day, and day of the week
• Base fees and per-mile additional
• Provider

When you factor in all of those things a simple ride based on where you live could become severely expensive without insurance. Fortunately, the cost of non-emergency medical transportation services is covered by Medicare or Medicaid in most instances. You can also check out the list of insurance carrier links for assistance on whether or not your insurance provider is available. Here are a few names you’ll be able to get more information on:

• AARP | Medicare Supplement (United Healthcare)
• Aetna Better Health
• Aetna Health Care
• Advocate Heath Care
• Beech Street Network
• Blue Cross/Blue Shield of Illinois (BCBS)
• Care Improvement Plus
• Cigna Health Care
• Cigna HealthSpring
• Coventry Health Care
• Evercare Health Plans
• Illinois Department of Healthcare and Family Service
• Health Alliance
• HealthLink
• HealthSmart
• HFN, Inc.
• Humana
• Illini Care Health Plan
• Illinois Department of CMS (Medicare/Advantage)
• Land of Lincoln Health
• Medicare
• Meridian Health Plan
• Molina Healthcare
• Multiplan PPO
• Mutual of Omaha
• Preferred Network Access, Inc.
• Railroad Medicare
• Unicare
• United Healthcare
• WellCare Medicare, HMO, Select

FAQs

These FAQs serve as a starting point for individuals seeking information about billing and insurance in the NEMT industry, addressing the common concerns and providing valuable insights.

How much does NEMT cost? 

The cost of NEMT varies. It can increase or decrease based on the destination of your drop-off, how long the ride is, weather, and time/day of your ride, just to name a few.

What steps should NEMT companies take to verify patients’ insurance coverage before providing transportation services?

In an ideal world, NEMT providers should improve patient eligibility by verifying patient insurance ahead of time to proactively solve coverage issues up-front. Unfortunately, that isn’t always the case.

Are there any special considerations for Medicare and Medicaid billing in the NEMT industry?

Medicare and Medicaid covers the cost of non-emergency medical transportation in most instances. However, you’ll want to verify prior to your ride that your insurance plan covers the cost of your transportation.

What are the common challenges faced by NEMT companies when dealing with insurance companies?

Transparency in reporting is a major challenge faced by NEMT companies when dealing with insurance providers. That’s why Elite Ambulance works diligently with our insurance partners to ensure that you, the patient, is given the most accurate information possible.

What are the consequences of inadequate insurance coverage in the NEMT industry? 

The primary consequence of utilizing NEMT without adequate insurance is higher cost of rides. In some instances, these rides can increase by hundreds of dollars and cause a financial strain on the patient that they could have avoided by properly verifying their insurance coverage pre-ride.

In conclusion, mastering billing and insurance in the non-emergency medical transportation industry is essential for smooth operations and financial stability. By implementing the tips and strategies discussed, NEMT providers, like Elite Ambulance, help patients navigate the complexities with confidence, ensuring optimal reimbursement and uninterrupted service for those in need. If you’re looking for more information regarding your billing and insurance needs, do not hesitate to reach out to Elite Ambulance corporate with any questions or concerns!