Many common questions can be answered by reviewing the frequently asked questions below. Clicking the link for the question will display its answer.
If you need to print out the frequently asked questions, click on the Convert FAQs to PDF link below and follow the directions.
Yes, billing invoice forms are required to be submitted with all original daily trip logs.
No, NEMT transportation providers must contract with Modivcare. Modivcare is the DMAS contracted Transportation Broker that is responsible for assigning and paying for FFS Medicaid transportation.
No, NEMT transportation requests are preauthorized, assigned, and paid for by Modivcare.
No, billing invoice forms and trip logs cannot to be faxed or emailed. The original documents must be sent via USPS mail, FedEx, UPS etc. and must be received by 5 PM EST on or before the “Invoice Due to Claims Center” date.
Yes, for assistance please call Modivcare at 866-386-8331.
Your attendant payment will be listed in the “Attendant” column of the Modivcare Batch Verification Detail Report.
Resubmissions should be sent to the claims center with the trip logs and the reason for resubmission. Complete the Resubmit Form. If you feel the information you submitted is accurate and need assistance making corrections, please contact the Utilization Review Department.
Contact your Regional Office and request an EFT (Electronic Funds Transfer) form. Complete the form and return it to the claims center for processing.
It normally takes 3- 4 weeks to process an EFT application. If you decide to cancel your EFT, please complete another EFT form to cancel the transfer. This should be done 2-3 weeks prior to your next payment. Download the file or contact your Regional Office and request an EFT (Electronic Funds Transfer) form.
Claims received by the Invoice Due to Claims Center date (see Virginia Provider Payment Schedule) will be processed by the following Check Disbursement Date.
Please allow a minimum of ten (10) business days from the date the check was disbursed before contacting the claims center. After you have allowed a minimum of ten days, please contact the claims center at 866-907-1502. Only after ten business days will Modivcare stop a payment and reissue a check. If you are using EFT, please allow twenty-four (24) hours for the monies to post to your account.
Please reconcile your invoice against the Batch Detail Report, there may be denied trips. If you feel that a trip was denied in error or omitted, please resubmit the trip for processing. Please include a copy of your trip log and the Resubmit Form with your resubmission.
Invalid Driver/Vehicle means that your driver and/or vehicle are not compliant with the requirements of the Transportation Agreement. Contact your Regional Manager and the Compliance Specialist Team immediately.
The claims center does not and cannot change mileage. Any mileage discrepancies will have to be discussed with your Regional Office. Please refer to your Transportation Agreement regarding mileage. Mileage is calculated as the shortest distance in street or road miles from the pick-up point to the destination. If you believe there to be a mileage error, you must bring it to Modivcare’s attention before running the trip. Modivcare will review the trip or trips in question and may reference other software to verify the distance. Any correction remains the sole decision of Modivcare. If you are not satisfied with Modivcare’s decision regarding the mileage, you may reroute the trip. Performance of a trip constitutes acceptance of the mileage provided by Modivcare.
You can email the Modivcare Virginia Claims Center at [email protected]. You can also contact the claims department at 866-907-1502.
Billing invoice forms and trip logs are due by the dates on the Virginia Provider Payment Schedule for the current year.
Checks are mailed or payments are posted to your account on the Check Disbursement date indicated on the Transportation Provider Payment Schedule.
Modivcare’s Claims Center
798 Park Avenue NW
Norton, VA 24273
Trips can be denied for various reasons (invalid driver, no pick up time, no signatures, no drop off time, no per trip billed amount, non-compliant vehicles/drivers, etc). Denial reasons will be listed on the Transportation Provider Detail Report.