Nevada Facility Resources

Quick Links:

Serving patients across all of Nevada

Welcome to the Modivcare Facility web site for Nevada. Currently this site hosts information and forms that medical facilities and medical groups can use to schedule transportation for our clients.

The forms on this site are stored in PDF Format. Your computer must have Adobe Acrobat Reader installed for you to be able to read and print the forms. If you do not have a copy of Adobe Acrobat, you can download it for free at www.get.adobe.com/reader/.

GettyImages 523087816
Allwell from SilverSummit Health Plan:
 
HCSC Group Retiree
 

Forms

Please click on the title that corresponds to the document you would like to view.

Member FAQs

  • Are pharmacy trips covered?

    Pharmacy trips are a covered service and can be requested to be added to an existing reservation on the same day but not guaranteed. Pharmacy trips must be scheduled like any other reservation. If the member needs to fill or pick up their prescription, we will schedule for same day or the next day, at the very latest.

  • Can a driver go into the member’s place of residence and assist them out to the vehicle?

    Drivers cannot go into the home, lift passengers or carry wheelchairs up and down stairs. Modivcare is a curb to curb service; door to door service may be requested but is not guaranteed. Members may wait indoors due to extreme weather but must look out for vehicle at the scheduled pick-up time.

  • How are discharges and transfers arranged by a facility?

    Hospitals/facilities can contact our Facility department 24/7 at 1-888-737-0830. Dedicated call takers are assigned to handle discharges/transfers. Once the discharge/transfer is arranged with our facility department, the transportation provider has up to eight (8) hours to respond and pick up the member. A discharge order and/or a discharge summary will be requested to be faxed over for transfers to another facility, i.e., skilled nursing home, rehabilitation, LTAC, etc. A Consent and Release of Liability form will be required from your facility to transport a minor from a facility to another facility with no adult escort (Consent & Release of Liability form may be downloaded from this website.

  • How can the Facility Department help?

    Modivcare maintains a facility department dedicated to handling the needs of facilities such as hospitals, dialysis, mental health, substance abuse clinics and adult daycares, etc. A dedicated staff and phone number (1-888-737-0830) is available to schedule reservations, to answer your questions or address your concerns.

  • How do I schedule a single trip reservation for a Modivcare member?

    You can contact our facility department at 1-888-737-0830 to schedule a reservation to the nearest appropriate Medicaid provider. You can schedule reservations up to 30 days in advance. Reservations are only scheduled Monday thru Friday from 8:00 am to 5:00 pm PST. If your facility is registered to use our Facility Services Website, then a registered user at your facility can submit the single trip requests online 24/7.

  • How long is a driver expected to wait at the member’s designated pick up location?

    A member should be ready fifteen (15) minutes before the scheduled pick up time. The driver is considered on time if he/she arrives fifteen (15) minutes before or after the scheduled pick up time. The driver is required to wait up to fifteen (15) minutes after the scheduled pick up time.

  • Is Modivcare transportation available to everyone?

    Medicaid transportation through Modivcare is available to any eligible Medicaid recipient (Managed Care Organization and Fee For Service). Please contact our facility department at 1-888-737-0830 with the member’s Medicaid number to inquire if a member is eligible for our services. Members (recipients) who have alternate means of transportation, such as a vehicle in the home, use of mass transit or a friend/family member to transport, should utilize those means and can receive bus tickets or gas mileage reimbursement if applicable. However, when there is no other options for transportation, Modivcare will provide a means of transport to covered services.

  • What are examples of emergencies?

    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.

  • What are the benefits of our Facility Services Website (FSW)?

    As a registered user you will be able to manage your patient/clients’ standing orders or single trips online without having to make a phone call or access a fax machine, 24 hours a day , 7 days a week. You will be able to request new trips, submit changes and best of all, review the status on all your requests. You will have the ability to add any facility staff as a user so that they can also access the FSW. Our Facility Services Website is a secured website and compliant with all HIPAA and PHI rules and regulations.

  • What happens if the transportation provider has not arrived according to the scheduled pick-up time?

    Modivcare maintains a 24 hour staff to resolve any concerns when a transportation provider is late or fails to show at the scheduled time. A dedicated phone line for our members is available to call and find out the status of the ride. The line is called the “Where’s My Ride” and the phone number for members to call is 1-888-737-0829. Facility personnel can contact a facility representative at 1-888-737-0830 for status on a ride.

  • What if a Facility has an emergency trip?

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

  • What if a Facility has an urgent/same day trip?

    Urgent/same day trips can be scheduled through Modivcare 24/7. Such trips should be for true urgent conditions where a physician is requiring the member be seen the same day or the next day. Verification from the treating facility/doctor that the appointment is of an urgent (non-emergent) nature is required. Dialysis, chemo/radiation, hospital follow-ups and wound care are examples of medically urgent appointments that cannot be rescheduled.

  • What if a return pick-up time for a member cannot be provided when scheduling a reservation?

    If a return pick-up time cannot be scheduled because the duration of the appointment is not known then a “Will Call” can be set up for the return pick-up time. The member will call the “Where’s My Ride” phone number at 1-888-737-0829 when they are done with their appointment and request the ride for the return (member needs to have their confirmation number or Medicaid number on hand). The transportation provider will be dispatched and will have up to 90 minutes maximum to pick up the member although most of the transportation provider’s turnaround time is within the hour.

  • What if the member’s appointment cancels?

    Modivcare must be notified as soon as possible (24 hour advance notice required if feasible). For Standing Order cancellations of a week or more, a cancellation form must be submitted. Cancellation forms may be downloaded on this website.

  • What is a Standing Order?

    Standing orders are reservations scheduled by approved facilities that are automatically scheduled for members who attend their facilities three or more days a week, with the same schedule. This allows a facility to arrange trips in advance for a member scheduled for ongoing treatment. The following types of treatment are accepted as standing orders: dialysis, mental health day programs, supported employment, substance abuse and adult daycare. Facilities who set up standing orders must comply with the standing order criteria. Please contact our facility department for more information at 1-888-737-0830.

  • What is the Facility Services Website (FSW)?

    The Facility Services Website is our Modivcare web based tool which allows facilities with registered users to be able to set up Standing Orders as well as single trip reservations online from the convenience of their computer. Please contact a facility representative at 1-888-737-0830 for more information.

  • What levels of service are covered through Modivcare for Non-Emergency Transport?

    The level of service describes the type of service needed to transport a member. A member can travel by one of several levels of service. Members will receive an assessment to determine the mode of transport based on each member’s level of care. Please contact a facility representative for further information. See below:

    • Gas Mileage Reimbursement – The member or the legally responsible individual (LRI) must use their personal vehicle as a mode of transport in exchange for expense reimbursement on a per mile basis at the current Federal Medical/Moving Rate. Modivcare must pre-authorize mileage reimbursement prior to your appointment. You can download the gas reimbursement forms on this website.
    • Gas Mileage Reimbursement/Volunteer Drivers – A volunteer driver is a friend, neighbor or family member who is not legally responsible for the member. Volunteer Driver’s perform transportation services strictly as a volunteer in exchange for gas mileage reimbursement on a per mile basis at twice the current Federal Medical/Moving Rate. Modivcare must pre-authorize mileage reimbursement prior to your appointment. You can download the gas reimbursement forms on this website.
    • Mass Transit – When available and suitable for the physical condition of the member. Modivcare will provide mass transit tickets or passes for members traveling near a bus route within 3/4 of a mile. Members who are certified with para transit must ride with para transit but will be covered through Modivcare for the expense to any Medicaid covered appointments. Exceptions for curb to curb transport will be provided when the nearest appropriate Medicaid provider is not within the ADA Zone or when gas reimbursement is not an option.
    • Ambulatory – This is a member who is able to walk on their own or with the assistance of a walker or cane but for medical reasons cannot ride public transit. This level of service also applies to members with manual wheelchairs that are able to transfer on their own. This curb to curb level of service requires an approved letter of medical necessity or a *Physician’s Transportation Restriction form.
    • Wheelchair – Available to members confined to a wheelchair that due to either physical weakness or mental impairment they must travel with their own manual or power wheelchair/scooter. If assistance is needed, please inform Modivcare at the time the reservation is called in. Transportation companies do not provide escorts or wheelchairs. This curb to curb level of service requires an approved letter of medical necessity or a *Physician’s Transportation Restriction form.
    • Stretcher – Available to members who cannot be transported in a wheelchair due to either a physical weakness or may be bedridden. Members must not require any monitoring during transport. This level of service requires an approved letter of medical necessity or a *Physician’s Transportation Restriction form for any rides other than discharges or transfers.
    • Bariatric – Applies to members that require specialized services/equipment due to their height & weight. Bariatric transports are reserved for individual needs that exceed standard gurney transport. This level of service requires an approved letter of medical necessity or a *Physician’s Transportation Restriction form.
    • Escorts – Applies to members that are minors or if for medical reasons, an adult requires an escort. A member who is approved for a PCA qualifies for an escort. An escort must be ambulatory and 18 years or older. Transportation companies do not provide escorts. Request for an escort requires an approved letter of medical necessity or a Physician’s Transportation Restriction form unless the member is a minor. Both parents may escort a member who is a minor less than twelve (12) months old.* A Physician’s Transportation Restriction form can be downloaded on this website.
  • Who can submit a Standing Order request on the Facility Service Website (FSW)?

    Standing order requests can only be submitted online by registered users. Please contact a facility representative at 1-888-737-0830 for further information.

  • Who gets notified if changes need to be made to a Standing Order?

    Our facility department must be notified of any temporary or permanent changes to a standing order. Our system will continue to automatically schedule trips with the original information unless we are notified of a change. Any changes given to a transportation provider will not be processed. All changes that are for a week or more will be required to come from the treating facility and will need to be submitted online through our FSW by completing a new standing order request; a cancellation form will also be required to cancel the current standing order. Please contact a facility representative at 1-888-737-0830 for more information.