Virginia Members

MTM Health provides rides to eligible FFS Medicaid members who are attending a Medicaid-covered service. You must have no other way to get there. Only Medicaid members who are excluded from Managed Care programs can receive rides through this program. This may include:

• Medicaid members who are newly eligible and have not been assigned to a Managed Care program
• Medicaid members who have received a home or community-based waiver and have not been assigned to a Managed Care program
• Medicaid members who are not otherwise enrolled in a health plan

You may be entitled to transportation from your Managed Care program. Refer to your Managed Care benefit handbook. You can also contact your Medicare health plan for more information.

There are several ways you can book a ride:

• You can use the web chat feature located on this website to chat with an agent in real time.
• You can use the MTM Link web portal or MTM Link Member mobile app; visit mtm-inc.net/mtm-link for more information and to register.
• You can call us at 1-866-386-8331 (TTY: 711).

Please note the following:

• You must schedule your ride at least five business days before your appointment, unless your trip is urgent. We may verify your appointment is urgent with your health care provider. You can schedule a ride 24 hours a day, seven days a week.
• Gas mileage reimbursement (GMR) trips can be scheduled the same day as your appointment. GMR requests must be called in prior to your appointment time.

When you call, please be ready to provide:

• Your name, date of birth, and Medicaid ID number.
• Your pick-up address and phone number.
• Your drop-off address and phone number.
• The date and time of the appointment.
• The time you will need to be picked up after the appointment, if known.
• Your health care provider’s name and phone number.
• The type of appointment you are going to.
• Any special needs, including:
  • If you need someone to ride with you. You are allowed to have one person accompany you.
  • If you will be bringing a car seat.
  • If you use a wheelchair or walker.

Rides can be arranged by yourself if you are at least 18 years old, or if you are emancipated. If you are under 18, your ride can be requested by:

• A parent or legal guardian.
• An authorized representative.
• Your DMAS Case Manager.
• Your health care provider.

Urgent rides do not require five business days’ notice. Urgent rides can be scheduled 24 hours a day, seven days a week. Call us at 1-866-386-8331 (TTY: 711) to schedule an urgent ride. We may verify your appointment is urgent with your health care provider.

Urgent trips may include rides to and from:

• Pre-op appointments
• Dialysis
• Methadone clinics
• Wound care
• Hospital or ER discharges
• Urgent care facilities
• Facility to facility or hospital to hospital transfers
• Drug rehab
• Follow-up appointments after a hospital or ER discharge
• Outpatient surgeries
• New medical conditions or tests

Please note, MTM Health does not schedule emergency rides. Call 911 if you have an emergency.

We will schedule your return ride as a will call. Once your visit is over, call us at 1-866-386-8331 (TTY: 711). Your driver should arrive within 45 minutes.

You will receive the ride that is best for you. We may consult your health care provider. Based on your needs, we will offer you:

• Gas mileage reimbursement (GMR) if you, a friend, or family member can drive to the appointment. The driver must submit a valid driver’s license, vehicle registration, and proof of insurance to MTM Health.
• Fixed route bus tickets if your pick-up location and destination are within ¼ mile of a bus stop. You must be able to walk there independently and safely.
• Ambulatory/sedan, van, or taxi services if you can walk between the door of your pick-up location/destination and the vehicle. This may include taxi services or on-demand transportation services like Uber or Lyft.
• Wheelchair van/paralift services if you cannot transfer from your wheelchair into a vehicle. Your wheelchair will be safely secured in the vehicle.
• Stretcher van services if you need to be transported on a stretcher but do not require medical care during transit.
• Non-emergency ambulance services if you need to be transported on a stretcher and require medical care during transit.

You will also receive the level of service that best meets your needs. This may include:

• Curb-to-curb service. This is the default level of service. It is for members who need little to no help during the ride. This level of service is for some ambulatory/sedan, van, and taxi services and some wheelchair van/paralift services. The driver will:
  • Open the vehicle door.
  • Assist you in and out of the vehicle at the curb.
  • Help you store or secure a wheelchair or other mobility device if necessary.
  • Make sure you walk in safely. The driver will watch you walk into the facility or residential site.
• Door-to-door service. This level of service is for members who need help to safely get from the door of the pick-up location to the door of the vehicle. This is for some ambulatory/sedan, van, and taxi services and some wheelchair van/paralift services. We may consult your health care provider to see if you need this level of service. The driver will:
  • Assist you from your home door, to the vehicle, and to the door of your destination.
  • Help you the entire way.
  • Never lose sight of the vehicle.
  • Not enter your residence, unless they are ambulance or stretcher van personnel.
• Hand-to-hand service. This level of service is for members who need help from a family member, facility staff member, or other responsibility party. This is for some ambulatory/sedan, van, and taxi services; some wheelchair van/paralift services; all stretcher van services; and all non-emergency ambulance services. We may consult your health care provider to see if you need this level of service. The driver will:
  • Receive you from a person at the pick-up location and hand you off to a caregiver at the door of the drop-off location.
  • Never lose sight of the vehicle for these trips.

You, a family member, or friend may be eligible for GMR payment for driving to a covered service. The vehicle must be safe and compliant with state and local requirements.

To receive reimbursement, you must complete the following steps:

1. Call MTM Health at 1-866-386-8331 (TTY: 711) as soon as possible after scheduling your appointment. Five days advance notice is not required for GMR. You can schedule your GMR trip the same day as your appointment. Please call before your appointment time.
2. Your driver must submit a valid driver’s license, vehicle registration, and proof of insurance to MTM Health. Email copies of these documents to MyInfo@mtm-inc.net.
3. On the day of your trip, complete a paper Trip Log. You may download a Trip Log under the Forms and Other Documents section of this website. You may also call and request one be mailed to you. You may also use the MTM Link Member mobile app to claim your trips without a Trip Log. The app is available for free on Apple and Android devices. You will start and end your trip in the app to submit your claim automatically.
4. If you are using a paper Trip Log:
   • Make copies of your blank Trip Log in case you need to make changes.
   • The Trip Log must be signed by a healthcare professional at your appointment. This includes nurses, therapists, physician assistants, or nurse practitioner. It doesn’t have to be the doctor.
   • A round trip is from your home to the appointment, then back home. Round trips should be entered on one line with the round trip box marked. If you are going from one appointment to another appointment before going home, please enter each trip leg on a separate line. For example:
     • 1st leg- home to first doctor
     • 2nd leg- first doctor to second doctor
     • 3rd leg- second doctor to home
   • Email the completed log to payme@mtm-inc.net. Please submit your Trip Log no more than 60 days past the date of the first appointment.
5. Keep a copy of your Trip Log for your records.
6. You or your driver will receive payment on a reloadable debit card.

If you have questions about the reimbursement process, please call 1-866-386-8331 (TTY: 711).

If you need rides to Medicaid-eligible appointments on a daily, weekly, or other routine basis, your health care provider must schedule your repeating/standing order trip. They may schedule repeating/standing order trips for up to six months at a time for services such as:

• Dialysis
• Chemotherapy
• Radiation treatment
• Infusion therapy
• Methadone maintenance
• Physical or occupational therapy and rehabilitation services
• Mental or behavioral health therapy
• Wound care
• Adult day care
• Supportive employment

Minors aged 12 and under must be escorted by an adult at all times. The escort must be at least 18, unless they are the parent. Minors aged 13 to 17 may travel alone. The parent or guardian must complete a Minor Consent Form first. Call us at 1-866-386-8331 (TTY: 711) for more information.

Yes. The hospital discharge nurse will contact MTM Health to schedule a ride home for you. Your care team at the hospital can also use the MTM Link Facility Portal to schedule your ride on your behalf. Once a discharge is called in, the driver has up to three hours to pick you up from the hospital.

No. Call 911 if you have an emergency. An emergency is when an immediate medical response is needed for a condition that threatens life or limb. Some examples of emergency situations are:

• Broken bones
• Bleeding that will not stop
• You are pregnant, in labor, and/or bleeding
• Trouble breathing
• Chest pains
• Suddenly unable to see, move, or talk

Yes. Urgent care is not emergency care. Urgent care is needed when your condition is not life threatening but must be treated within 48 hours. For example: flu symptoms, ear aches, sore throat, or COVID testing.

You can request a ride to the pharmacy at the same time you request your ride to your health care provider. If you find out at the appointment you need to go to the pharmacy, call MTM Health to add a pharmacy stop to your return trip. You will need to give the name and address of your pharmacy.

You can request a certain transportation provider. We will note it. However, MTM Health cannot guarantee your transportation provider of choice.

On the day of your ride:

• Be ready for your ride at least 15 minutes before your scheduled pick-up time. If your driver has not arrived 15 minutes after your scheduled pick-up time, call MTM Health.
• If you scheduled a ride back home during the original ride request, your driver should pick you up within 15 minutes after your appointment is over. Call MTM Health if your driver is late or does not pick you up.
• If your visit is over and you did not schedule a ride back, call MTM Health. The driver should arrive within 45 minutes. Call us back if you have waited longer.

Call 1-866-246-9979 (TTY: 711) if you:

• Scheduled a ride back home during the original ride request and have waited more than 15 minutes after the requested pick-up time.
• Have waited more than 45 minutes after calling MTM Health to schedule a return ride, if a return ride was not scheduled during the original request.

Call 1-866-386-8331 (TTY: 711) if you need to cancel your ride or make any changes. You can also use the MTM Link Member mobile app to cancel or reschedule your ride. Please cancel your ride at least 24 hours in advance when possible.

You can expect certain rights and protections from MTM Health when accessing NEMT services. This includes your right to:

• Obtain pre-scheduled rides to Medicaid-covered services at no cost to the member.
• Confidentiality with your personal and medical information.
• Courteous, prompt service when scheduling your trips.
• Access safe, reliable transportation services.
• Be treated with respect and consideration of your dignity and privacy.
• Obtain explanations on why we may need more information or why a trip is denied.
• Access to all program information.
• File a complaint or grievance related to MTM Health’s services without fear of penalty or retaliation

When utilizing NEMT to travel to an appointment, you must:

• Inform MTM Health of any special transportation needs you have during scheduling. This includes if you plan to bring an additional passenger with you so we can ensure there is room in the vehicle. Only one additional passenger is allowed.
• Be dressed and ready for your ride at least 15 minutes prior to the scheduled pick-up time.
• Wait for your driver at the main entrance or door of the pick-up location.
• Supply the appropriate car or booster seats for children.
• Bring your own wheelchair or other mobility device if necessary.
• Cancel a ride you no longer need at least 24 hours in advance.

You must follow these rules while in a NEMT vehicle:

• You must wear a seatbelt.
• You may not eat, drink, or smoke. This includes e-cigarettes, vaping, and chewing tobacco.
• You may not bring or use alcohol or illegal substances of any kind on the vehicle.
• Profane or vulgar language directed toward other passengers or the driver will not be tolerated.
• Sexual advances or harassment will not be tolerated.
• You may not solicit, harass, annoy, or intimidate other passengers or the driver. Bullying is not allowed.
• You may not bring a weapon of any size or kind on the vehicle. This includes carried or concealed guns, even if you have a permit.
• You may not bring hazardous materials or items on the vehicle.
• You are responsible for all baggage and personal items. All items must be able to fit comfortably on your lap or beside you.
• Do not ask the driver to make additional stops on your way to or from your appointment.

Drivers must follow rules. These include:

• Drivers must identify themselves to you with a badge or uniform.
• Drivers must always be professional and courteous.
• Drivers must provide safe and on-time service.
• Drivers must arrive within 15 minutes before or after the scheduled pick-up time.
• Drivers must notify MTM Health immediately of known pick-up delays 15 minutes beyond the scheduled pick-up time. We expect drivers to be on time, but sometimes it is out of the driver’s control. When a driver notifies MTM Health of a delay, we will attempt to notify you and assist with other options, if available
• Drivers must only transport to the pick-up and drop-off locations listed on the trip reservation. Drivers cannot make additional stops during transport. This includes stops like fast food or shopping locations
• Drivers are not allowed to assist you with personal care, medication, or oxygen (unless traveling on an ambulance). If you require oxygen on an ambulatory or wheelchair trip, you must be able to self-administer oxygen.
• Drivers will return for pick-up to the location they dropped you off at, unless otherwise directed.
• Drivers must provide the required level of assistance (curb to curb, door to door, or hand to hand). At no time will a member with hand to hand level of assistance be out of the driver’s sight until the member is handed off to a person at the facility or residence.
• Drivers must secure each wheelchair forward facing with four securement straps and a shoulder and lap belt.
• Drivers must transport you within the approved travel time (the direct travel time plus 45 minutes).
• Drivers are to only use a hands-free mobile device when communicating with the dispatcher of their company.
• Drivers may not take personal calls.
• Drivers may not carry a member or their wheelchair up or down steps.
• In the event of an emergency during transport, the driver will pull off to a safe location and call 911.

Transportation providers and their vehicles and drivers must meet strict standards. Providers and their drivers must meet the following standards before transporting you:

• Pass a criminal background check
• Have a valid Virginia driver’s license
• Pass a Virginia Division of Motor Vehicle (DMV) driving record check
• Complete MTM Health driver training
• Complete defensive driving training
• Complete basic first aid training
• Complete wheelchair securement training, if they provide wheelchair level of service
• Wear a visible nametag and identify themselves
• Complete MTM Health’s vehicle inspection process twice per year; there will be a vehicle inspection sticker visible to you in the lower righthand corner of the passenger side rear window
• Conduct on-site monitoring with MTM Health’s staff, where our team verifies compliance at facilities and residential sites

MTM Health has several ways that you can get help with NEMT services:

• If you have questions about rides or need help scheduling a ride, call 1-866-386-8331 (TTY: 711). We can answer your questions. We can help you schedule a ride.
• If you have questions about gas mileage reimbursement, call 1-866-386-8331 (TTY: 711).
• If you need to reach US Bank Cardholder Services for help with your reloadable debit card, call 1-888-863-0681.
• If you need help using the MTM Link Member Portal or mobile app, call our Navigator Line at 1-888-597-1189 (TTY: 711). We can assist you in creating your account. We can also help you with any issues you have using the platforms.

MTM Health provides free aids and services to people with disabilities to communicate effectively with us, including:

• TTY/TDD services
• Written information in other formats, such as large print and Braille

If you need these services, call us at 1-866-386-8331 (TTY: 711). If you do not speak English, call us at 1-866-386-8331 (TTY: 711). We can help answer your questions in your language.

We arrange rides for Medicaid-eligible members to Medicaid-covered services There are situations where rides may be denied. Examples of common denial reasons are:

• A member cannot or refuses to provide requested information to determine the need for transportation services.
• A member is found to be ineligible for transportation benefits.
• A member fails to make a reservation for a routine appointment five business days in advance, unless the appointment is urgent.
• A member attempts to schedule a ride to a service not covered by FFS Medicaid.

You will be notified in a timely manner if your ride is denied. You can file an appeal if you do not agree with MTM Health’s denial decision.

We want you to be happy with your rides. Let us know right away if at any time you are not happy. This includes if you do not agree with a decision we have made.

If you are not happy with MTM Health or our providers, you can file a complaint by:

• Calling 1-866-386-8331 (TTY: 711)
• Visiting mtm-inc.net/contact
• Writing to us at:

MTM Health
16 Hawk Ridge Circle
Lake Saint Louis, MO 63367
Attention: Quality Management

Please file your complaint or concern as soon as possible. You must have the member’s date of birth and two additional pieces of information from the list below at the time of the call for verification and security purposes:

• NEMT trip reference number
• Member name
• Member date of birth
• Member Medicaid ID number
• Pick-up or drop-off location

MTM Health will follow up with you via phone call, email, or mailed letter.

If you disagree with a denial or other decision made by MTM Health, you can file an appeal. Within 30 days of your written denial, file an appeal with DMAS by:

• Calling 1-804-371-8488
• Writing to:
  Appeals Division
  Virginia Dept. of Medical Assistance Services
  600 Broad Street, 6th Floor
  Richmond, VA 23219

• Faxing 804-452-5454
• Visiting https://www.dmas.virginia.gov/appeals/appeals-portal/

The Appeals Division will contact you.