Arkansas Facility Resources

Member eligibility is determined by Arkansas Medicaid, general guidelines include:

• You must be on Medicaid.
• You must try to find another ride first — maybe with friends or family members.
• You must have no other way to get to your appointment.
• You must be going to or coming from a Medical Provider who bills Medicaid for the services you are receiving at your appointment.

Members whose Medicaid has the ME codes listed below are not eligible to receive NEMT services:

• 01- ARKids First- B Beneficiaries
• 18- Aid to the Aged- QMB
• 38- Aid to the Blind- QMB
• 48- Aid to the Disabled – QMB
• 88- Qualified Medicare Beneficiaries (QMB)
• 08- Tuberculosis (TB) category
• 62- Pregnant Woman Presumptive Eligibility
• 69- Family Planning-Women’s Health Waiver (Family Planning FP-W)

A Member is not eligible for NEMT if they:

• are in a nursing home
• are in an ICF/MR (a home for people with mental retardation).
• are a qualified Medicare beneficiary (QMB).
• qualify for Medicaid only under the family planning waiver or tuberculosis program.
• * Issues concerning Members medical eligibility codes must be addressed with Medicaid directly.

Additionally Modivcare only serves Medicaid Members within the following counties:

Modivcare offers facility staff who are dedicated to handling the reoccurring non-emergency medical transportation (NEMT) needs of eligible Medicaid Members with regular appointments at healthcare facilities. For example: Members who need transportation three days each week to and from dialysis.

Discharges will be accepted 24 hours a day 7 days a week; however, it is recommended to call during our operation hours of 8am to 5pm CST. If transportation is required for a Saturday discharge, contact Modivcare as early as possible the prior Friday to submit your request. It is particularly challenging to secure transportation on a weekend. Advance notice may alleviate delay in fulfilling transportation requests.

Cancellations should be called in at least 2 or preferably more hours before the scheduled pick-up time.

Modivcare maintains staff to resolve any issues when a Transportation Provider is late or fails to show at the scheduled time. A dedicated phone line is available to call to find out the status of the ride. The line is called the “Where’s My Ride” line and the phone number to call is 866-854-8855.

Commonly at the time of pick up, Transportation Providers will provide a business card with the company’s contact number. Once a Member’s appointment is finished, he/she or someone at the medical provider’s office should contact the transportation company at the listed number to arrange a return ride. If no response is received or if the Transportation Provider does not arrive timely, call the “Where’s My Ride” phone number at 866-854-8855 and request that transportation be sent to pick up the Member. A Transportation Provider will be dispatched and pick up the Member within 60 minutes.

Urgent/same day trips can be booked through LGTC 24 by 7. Such trips should be for true urgent conditions where a physician is requiring that the Member be seen the same day or next day. All urgent/same day trips will be verified with the physician’s office for medical necessity. If it is a case where the trip was just not called in a timely manner, the appointment should be rescheduled to accommodate the 48 hours business notice requirement.

For example:

Examples of such trips are doctor appointments deemed urgent by the physician and hospital discharges.

Emergency ambulance trips are not arranged through Modivcare. If an emergency ambulance trip is needed, 911 should be called.

Sudden life threatening medical situations, significant trauma, comas, shock, uncontrolled bleeding, respiratory distress, poisoning, drug overdose, and any situation where immediate medical relief or treatment is necessary.

Hospitals contact the Reservation Line

• In Region 3 that number is 866-854-8764
• In Region 7 that number is 866-854-8764
• In Region 12 that number is 866-854-8788

Discharges must be called in by a doctor, nurse, or social worker. Once assigned, typically transportation will arrive within three (3) hours. Every effort will be made to arrive as soon as possible. Facilities or hospitals arranging transportation on behalf of a Member must provide accurate and verifiable information regarding transportation, including contact information for the Member and facility.

No.

The level of service describes the type of transportation service needed to transport the Member. A Member can travel by one of several levels of service based on his/her medical needs and mobility.

Gas Reimbursement

• Member has a vehicle (or access to vehicle of friend, neighbor, or family Member).
• Vehicle is operable (and is available at the time of the Member’s medical appointment).
• Member is physically able to drive the vehicle (or Member’s friend, neighbor, family).
• Member requires financial assistance in order to attend the medical appointment (i.e., gas or mileage reimbursement).

Bus Pass/Mass Transit

• The Member lives within 1/8th of a mile of a bus stop.
• The medical facility is within 1/8th of a mile of a bus stop.
• Bus passes can be obtained by calling LGTC.

Ambulatory

• The Member can walk unassisted from doorway of residence to the curb.
• The Member can walk unassisted from the vehicle to the medical facility.
• The Member can transfer from the wheelchair to the seat of an ambulatory vehicle.
• The Member’s wheelchair folds and can be placed in the rear of the vehicle.

Wheelchair

• The Member must use a wheelchair to travel.
• The Member cannot transfer from the wheelchair to the seat of an ambulatory vehicle.

Modivcare’s Transportation Providers are not medical personnel. While each driver has First Aid and CPR certification they cannot monitor medical equipment, (i.e. Oxygen, Feeding pumps).

No, at this time no Medical Necessity Form is required, although Modivcare may call the medical provider to confirm that need.

Their “preference” will be taken into consideration but cannot be guaranteed.

15 minutes from the scheduled pick-up time.

Modivcare of Arkansas requires that Members under the age of 13 be accompanied by a parent or attendant. Many Transportation Providers employ Attendants who are trained to monitor and assist passengers while they are on route. Children 13 years old and up may travel unaccompanied, but must have a legal adult available at his/her destination to sign the trip log documentation.

Along with the driver credentialing process and training, each vehicle operated by a NEMT provider must undergo an initial 45 point vehicle inspection by a Modivcare Field Monitor before that vehicle can be used to transport NEMT Members. Once approved, each vehicle is regularly re-inspected at least twice annually. All vehicles are subject to random and on-site inspections while on route. Wheelchair vehicles receive more in-depth inspections with regards to the special equipment needed for transport. Once inspected, a Modivcare window decal is applied to the vehicle. This provides for a quick visual identification of a Modivcare approved vehicle.

No.

A Member may request a preferred provider. Modivcare will attempt to schedule transport with the preferred provider but cannot guarantee the assignment because we cannot guarantee that the provider will be available for the specific trip.

A Member may request not to ride with a specific provider. Modivcare will investigate any incident that causes such a request and make an appropriate determination.

All Modivcare approved NEMT providers are required to meet a rigorous credentialing standards. This process mandates that all drivers must have a current driver’s license and a clean driving record. All attendants and drivers must test negative on a stringent drug test, undergo a criminal background check in addition to screenings by Adult and Child Maltreatment Registries. Once all information is received, Modivcare’s Compliance Department will review it to make sure the driver and/or attendant meets all the standards set forth by the State of Arkansas. The driver and/or attendant is then either approved or denied to transport Members for Modivcare. Once approved to transport Arkansas Medicaid Members, each driver and/or attendant must obtain a national certification for Defensive Driving, First Aid and CPR, and Passenger Assistance Sensitivity Certifications, as applicable. Modivcare offers a certification program to each provider through the National Safety Council, the American Heart Association and Community Transportation Association of America.

A copy of the Standing Order Request Form is located at this web site and can be downloaded for your convenience. Alternately, the Modivcare Facility staff can fax the form to you.

Call the Facility Department at 866-854-8882 to change or update a standing order.

If a pick up time has not previously been scheduled the driver will arrive within 60 minutes of when the Member has called for a return trip.

Medicaid transportation through Modivcare is only available to eligible riders who do not have an alternative means of transportation.

Riders with a vehicle in the home, access to mass transit, or a friend/family member with the ability to transport him/her, should utilize those options first. Modivcare can help with gas reimbursement or mass transit (bus) passes when these options are available.

When there are no other options for transportation, Modivcare will arrange transportation to approved medical appointments.

Arkansas Medicaid standards require that if a request for NEMT falls under one or more of the denial criteria listed below, then Modivcare must deny the request:

• The Member is not eligible for NEMT on the date of service.
• The Member does not have a medical need that requires NEMT.
• The medical service for which NEMT is requested is not a covered medical service.
• The Member has access to other transportation.
• The medical appointment is not scheduled or was not kept.
• The trip was not requested in a timely manner and cannot be accommodated. Additional documentation was requested and was not received in a timely manner.
• The Member refuses the appropriate mode of transportation.
• The Member refuses the NEMT provider assigned to the trip and another appropriate NEMT provider is not available.
• The Member exhibits uncooperative behavior or misuses/abuses NEMT services.
• The Member is not ready to board a NEMT transport within fifteen (15) minutes after the scheduled pick up time.

It is regularly reoccurring transportation for those Members who need transportation three (3) or more days per week for a duration of three (3) or more months (e.g., a Monday, Wednesday and Friday dialysis patient). Standing orders are available for Members needing transportation for ongoing, sustaining medical treatment and to eliminate the need to call the reservation line to schedule each of those trips. Trips must be for services that are permanent or infinite in nature (i.e. Dialysis) and not for services with a treatment plan that by nature improves to the point of discontinuing care (i.e. physical or speech therapy). The standing order process allows a facility to arrange transportation for a three (3) month period by simply filling out and faxing in the standing order form. At the end of those three (3) months our Facility Department will call the healthcare facility and confirm trip continuance. The facility will not have to submit a new standing order at that time unless there is a change in the Member’s mobility, contact information, or appointment schedule. A request for Standing order will be evaluated based on type and length of treatment, Member attendance to Transportation, Facility adherence to Standing Order Reporting compliance among other requirements.

All transportation companies should attempt to contact the Member within 24 hours in advance to identify themselves and to convey the expected pick up time. In cases where the NEMT providers are not notifying the Members in advance, the Member should call Modivcare at 866-854-8855.

On time or early – but not more than 30 minutes early.

On time. A member should be ready fifteen (15) minutes before the agreed pick up time. The vehicle is considered on time if it arrives 15 minutes before or 15 minutes after the designated pick up time. The driver is required to wait up to 15 minutes from the member’s pick up time to transport.

The Standing Order Request Form should be faxed to the Modivcare Facility Department at 866-854-8882.

Modivcare maintains Quality Assurance staff to address and record issues related to NEMT.

Social workers, case managers or other licensed/certified medical professionals. If a Member requests regularly reoccurring transportation for three (3) or more days per week for a period of three (3) months or more, then the Facility Department will contact the social worker or case manager to secure a Standing Order for the Member.