Providers' Frequently Asked Questions about NET
1. Who is qualified for the NET program?
2. What if the beneficiary needs a same-day appointment?
3. What other instances require that a PCP office call the transportation broker?
4. What if a beneficiary's ride doesn't show up?
1. Who is qualified for the NET program?
Qualified beneficiaries must be enrolled in Medicaid and have no other means of transportation. "No other means" signifies that they have already tried to get transportation through friends and family. The beneficiary must provide the transportation broker with an explanation of why he or she needs a ride. Transportation must be scheduled at least 48 hours prior to the beneficiary appointment. Additionally, the recipient must show proof of eligibility (i.e., Medicaid I.D.) when transportation arrives. Please stress to your patients that they need to be ready when their ride arrives.
2. What if the beneficiary needs a same-day appointment?
If a PCP feels a beneficiary's medical condition is urgent, someone
from the physician's office must call the transportation broker
and explain that a same-day appointment is necessary. The broker
should then waive the 48-hour rule. The broker may request a fax
from the PCP stating the need for the urgent care.
3. What other instances require that a PCP office call the transportation broker?
A beneficiary needs care from a physician outside his or her region. If a recipient needs care from a physician outside of his or her region, the PCP must provide the broker with a referral.
A beneficiary has a regularly scheduled medical appointment. If a beneficiary has a regularly scheduled medical appointment (e.g., same time every week), the beneficiary and the medical provider both need to call the transportation broker. Some brokers will set up a regular transportation schedule. Others, however, will still require that the beneficiary call each week 48 hours in advance. Those beneficiary who have a regularly scheduled transportation appointment need to call their broker 48 hours in advance if they are going to cancel their appointment.
4. What if a recipient's ride doesn't show up?
The beneficiary should first call his transportation broker and report
the problem. Then he should call the toll-free MMCS Transportation
Help Line at 1-888-987-1200 to report the incident. MMCS logs all
calls and works with Medicaid and the brokers to
find satisfactory and timely solutions to such problems. MMCS also
provides Medicaid and the regional brokers with a quarterly report,
which indicates the number of inquiries and complaints received
per region. Medicaid uses these reports to monitor the quality of
the program.