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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.
FFS Non-Emergency Medicaid Transportation is for eligible members who need transportation to a Medicaid paid service and who are not enrolled in a Medicaid Managed Care Organization (MCO).
You may be entitled to transportation from your MCO plan. Some of the information on this website does not apply to MCO transportation. Refer to your MCO benefits handbook or contact your MCO plan for an explanation of transportation benefits. Use the following link for MCO transportation contact telephone numbers. : https://www.dmas.virginia.gov/for-providers/transportation/non-emergency-transport/ and look under the heading “Information” and click on “Transportation Contacts for Reservations and Ride Assist/Customer Service”.
Non-Emergency Medicaid Transportation is pre-scheduled, pre-authorized and medically necessary transportation to Medicaid-paid services such as medical appointments, waiver programs and dialysis.
Medically necessary transportation is defined as the most appropriate level or type of vehicle that can safely be provided to the member. NEMT levels of service include taxi (including sedans and mini-vans), non-emergency ambulance, stretcher van and wheelchair van. You may also have three alternatives: fixed-route public transportation, mileage reimbursement or Volunteer Driver.
You will need your Member Medicaid ID number, date of birth, name of doctor or facility, the scheduled pick up address, destination address, treating facility’s phone number, date and time of appointment, and return time.
Transportation is provided for Medicaid members who have no other means of transportation to a Medicaid-paid service and transportation is included in your Medicaid benefits. In case of a life-threatening emergency, call 9-1-1.
You can make a reservation on the Member Services Website (https://member.logisticare.com). You can call the NEMT reservation line at 866-386-8331 at least five (5) business days prior to the scheduled medical appointment. (Verifiable urgent trips, like a follow-up appointment or sudden, non-life threatening illness, may be reserved with less than five (5) business days’ notice.) Please have your Medicaid ID number and the necessary appointment information ready when calling the reservations line. You can also make a reservation using the Modivcare Member App. If you need to make transportation reservation with one of the MCOs please see Reservation telephone numbers at: https://www.dmas.virginia.gov/for-providers/transportation/non-emergency-transport/ and look under the heading “Information” and click on “Transportation Contacts for Reservations and Ride Assist/Customer Service”
If you usually go to the pharmacy after your medical appointment, please request the trip to the pharmacy at the same time you make your transportation reservation to your medical appointment. If you find out at the medical appointment you need to go to the pharmacy, you must contact Modivcare immediately at 1-866-386-8331. Request that a pharmacy stop be added to you return trip. You will need to give the name and address of your pharmacy.
Modivcare will ask you about your health condition and physical limitations in determining the most appropriate type of transportation.
Ambulatory is defined as
A wheelchair van is a motorized vehicle equipped specifically with a certified wheelchair lift, and wheelchair securement system designed or adapted to safely carry passengers in manual or electric wheelchairs and other mobility devices. Wheelchair van services can only be used in non-emergency transportation. They are limited to use by members who can sit upright, to members without acute medical problems that require them to remain in a horizontal position, and by members who use a mobility device.
Ambulance, as defined by Code of Virginia §32.1-111.1, means any vehicle, vessel or craft that holds a valid permit issued by the Virginia Department of Health, Office of Emergency Medical Services (OEMS) and that is specially constructed, equipped, maintained and operated, and intended to be used for emergency medical care and the transportation of patients who are sick, injured, wounded, or otherwise incapacitated or helpless. The word “ambulance” may not appear on any vehicle, vessel or aircraft that does not hold a valid EMS vehicle permit. Modivcare only provides non-emergency ambulance transportation.
A Stretcher-van is similar to a wheelchair van but it is designed to transport a passenger on a stretcher. It is used when a passenger must be transported in a prone position but does not need the medical services of an ambulance. Stretcher-van service does not provide emergency medical transport and does not include any medical monitoring, medical aid, medical care or medical treatment during transport. It requires a crew of two people on board to safely load and unload the stretcher.
Transportation for a routine appointment must be requested five (5) business days in advance. The day of the request does not count as one of the five days. The day of the appointment does count.
You will need the following information to complete the reservation:
Urgent reservations are defined as a trip to treat a sudden illness or other medical condition that is not life threatening but the member’s doctor or other healthcare professional wants to see the member in less than a five (5)-day notice. For example, a baby wakes up with a serious cold or and adult has an infection. Urgent care reservations are not for routine appointments or appointments where the member failed to notify Modivcare to arrange transportation.
Examples of such trips are follow-up appointments within five days, appointments deemed “urgent” by the physician, urgent MRI or CT Scan ordered by a physician, wound care, chemotherapy and radiation therapy. Modivcare will verify the urgency with the physician’s office.
Yes, all Medicaid-paid services are subject to verification or service authorization prior to transport.
Emergency ambulance trips are not arranged through Modivcare. If an emergency ambulance trip is needed, 9-1-1 should be called.
The “Ride Assist” phone number for the entire State of Virginia for Modivcare is 866-246-9979. MCO Ride Assist telephone numbers can be found at https://www.dmas.virginia.gov/for-providers/transportation/non-emergency-transport/ click on “Transportation Contacts for Reservations and Ride Assist/Customer Service”.
Examples are sudden life threatening medical situations, significant trauma, comas, shock, uncontrolled bleeding, respiratory distress, poisoning, drug overdose and any situation where immediate medical treatment is necessary.
A member’s transportation becomes “late” 15 minutes after the scheduled pickup time. Call the “Ride Assist” line and file a “Provider Late” complaint. Ride Assist can call the provider about the delay or try to find another provider for your trip.
The “Ride Assist” phone number for the entire State of Virginia for Modivcare is 866-246-9979. MCO Ride Assist telephone numbers can be found at http://dmas.virginia.gov/#/nemtservices click on “Transportation Contacts for Reservations and Ride Assist/Customer Service”.
Please refer to the chart below. In order to determine the region you are in, find the city or county in which you live and refer to the region number at the top of the column.
Your return trip can be scheduled as a “Will Call”. You will use the same “Ride Assist” phone number listed above. Once the appointment is finished, you or someone at the medical facility will call the “Ride Assist” phone number and request transportation to be sent to pick you up. The transportation provider will be dispatched and will have up to 45 minutes to arrive.
For questions, complaints or concerns, please call “Ride Assist” at (866) 246-9979 and speak with a customer service representative. The customer service representative will give you a tracking number for your complaint or concern. Please keep this number for future reference. You can also down load a complaint form at http://transportation.dmas.virginia.gov/Members/Downloads or http://transportation.dmas.virginia.gov/Healthcare-Facilities/Downloads. Instructions are included with the form.
If you rode with a MCO NEMT Program and want to file a complaint. Please look up the Ride Assist telephone number for your MCO at http://dmas.virginia.gov/#/nemtservices click on Transportation Contacts for Reservations and Ride Assist/Customer Service and call the Ride Assist number and discuss the complaint with the Customer Service Representative.
If you called in transportation reservations with Modivcare and they denied your transportation you will automatically receive a transportation denial letter. The denial letter will include your appeal rights. If you would like to file an appeal for any other transportation reason please go to http://transportation.dmas.virginia.gov/Members/Downloads and click on “Virginia Medicaid/FAMIS Appeal form. You can download and print the form. Please ensure you follow the directions included on the form.
Yes, members who are deaf and hard of hearing can dial 7-1-1 or use your preferred Relay Service to reach us at 1-866-386-8331 or TTY 1-866-288-3133.
Medicaid members do not have the freedom of choice to choose their transportation provider. A request can be made and will be noted by Modivcare. However, Modivcare reserves the right to utilize a different transportation provider consistent with the transportation needs of the member.
Transportation can be arranged by you, your representatives (such as family, friends, or case manager) or your Medical service provider.
Minors age 17 to 13 years of age can ride by themselves with the parent or guardian permission. The parent or guardian must sign the Consent form. Minors 12 and under must be escorted by a parent, guardian, relative or friend. If an escort will not be available, Modivcare will work with the transportation provider to provide an attendant to ensure so two adults will be on the van with the minor. The escort must be age 18 or over unless it is the parent. Minors 17 to 13 years of age may travel alone to certain after-school Medicaid-paid programs services if a Consent and Release of Liability Form signed by the parent or guardian is on file with Modivcare. Please contact the Utilization Review Department at 1-866-386-8331 for more information
Please refer to the Consent and Acknowledgement Form found on this website on the download navigator.
The Consent and Acknowledgement Form must be signed by the parent or legal guardian of the minor.
An escort is a family member, friend or facility employee who accompanies a Medicaid member (any age) for the entire trip and stays with the member at the destination. Modivcare is not responsible for providing escorts. There is no charge for an escort to ride with the member. Please let Modivcare know an escort is riding with the member at the time of calling in your reservation.
A transportation attendant accompanies a member or a group of members during transport only. The attendant is on the vehicle to ensure the safe operation of the vehicle and the safety of the members. The attendant is employed by the transportation provider. The attendant is not a medical professional and cannot provide any medical services. A transportation attendant will be provided for a member or a group of members when it is necessary for the safety of the member(s), to ensure timeliness of the trip and to reduce behavioral problems en route. Attendant requests need to be approved through Modivcare’s Exceptions Department before transport. Please call Exceptions at 1-866-386-8331 for assistance.
Requests for an attendant will be accepted from a qualified assessor, such as the member’s parent or guardian, the member’s case manager or social worker.
At the time of the request, an Attendant Care Eligibility Assessment form must be completed and faxed to Modivcare’s Exceptions Department at 866-907-1491.
You will find the Attendant Care Eligibility Assessment Form on this website on the download navigator.
No, attendants are for the safety of members while riding the vehicle only. However, the member can have an escort ride for free. When the transportation reservation is called in make sure and tell the customer service representative you have an escort riding as well.
Modivcare coordinates volunteer drivers to transport Medicaid members to and from their Medicaid covered service anywhere in Virginia. A Volunteer Driver is someone who is willing to share their time and vehicle to help meet the transportation needs of their community. The Volunteer Driver provides NEMT for local and long distance trips and receives mileage reimbursement.
Note: Volunteer Drivers have the same requirements as regular transportation provider’s drivers.
Mileage Reimbursement pays a member’s friend, neighbor or relative at the IRS Business rate per mile from the member’s residence to the Medicaid paid service and the return trip home. Mileage Reimbursement trips must be pre-authorized by Modivcare before transport. Modivcare assigns a unique trip number to the reservation. The trip number is needed to receive any reimbursement.
Prior to the trip, call Modivcare to schedule the transportation. When scheduling mileage reimbursement trips, you will need the name of the person who will be transporting the member as well as their telephone number and mailing address.
In order to be reimbursed, a Mileage Reimbursement Trip Log will need to be completed. The physician’s office must sign the trip log. The payee will mail the completed signed trip log to Modivcare’s Claims Department for processing. You still need to call Modivcare before the trip(s) is made to get a trip number for the trip log. If you fail to call in ahead of time, you will not receive reimbursement. You may also use the Member App for Mileage Reimbursement trips.
You will find the Mileage reimbursement Trip Log on this website on the download navigator. Contact Modivcare before transporting to receive prior approval and trip number for reimbursement. The trip number is required for reimbursement.
Please refer to the payment schedule in downloads.
Yes
Call the Modivcare reservations line at 866-386-8331 at least five (5) days before the scheduled medical appointment. This allows for proper delivery of the bus tokens, tickets, swipe cards or passes. Please tell the customer service representative the member will be using public transportation.
Yes. A copy can be accessed on this website on the download navigator.
Please call Modivcare’s the reservation line (866) 386-8331