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Star ratings suffer with broker, non-priority NEMT transports.

Updated: Feb 15


It's just about every day that 360 Quality Care + Transport Services encounters patients who, when using a broker to coordinate their non-emergency medical transport needs, are frustrated by their provider either running late, or worse, not showing up for their transport pick-up as promised.  It's always the same story - having to wait hours to either get to, or come home from a doctor’s appointment, or worse, being late to, or even missing their doctor’s appointment entirely. The frustrations are real, and often combined with a communication system that is much too hard to navigate and often fails to alert patients of the status of their ride.


Navigating the broker system

Transportation Brokers are the liaison between patients and non-emergency medical transportation (NEMT) providers. They are responsible for scheduling, coordinating, and managing NEMT services for eligible members - those who either qualify for Medicaid transport benefits or those whose Medicare Advantage programs provides transportation benefits. 

 

Brokers are responsible for verifying member eligibility, identifying and arranging appropriate modes of transportation, ensuring quality and safety standards, overseeing the credentialing of approved providers, providing a communication resource for eligible members, managing complaints and grievances, and paying providers. So why are so many patients left out in the cold?


Some of the most common reasons that result in a lack of performance are:

  • Lack of adequate network provider coverage. It results in a reduced capacity to meet the demand for NEMT services across large geographic areas.

  • Inefficient and outdated technology systems. It limits their ability to track, monitor, and optimize NEMT trips in real time and communicate with patients effectively.

  • Poor performers and unreliable NEMT providers. It leads to low patient satisfaction, missed appointments, and adverse health outcomes.

  • Rising administrative, liability, and operational costs. It reduces the profitability and sustainability of NEMT providers and their programs.

  • Inability to differentiate between members who should be considered priority. It fails to recognize those members who require essential and timely transportation in order to achieve optimal health outcomes, and those members who require other non-essential, less time sensitive medical transportation needs.

In today’s broker coordinated transportation world, there is no guarantee you won’t be late, or even miss your next doctor’s appointment, but there are some steps you can take to mitigate your risk.  


Plan ahead and schedule your NEMT ride as early as possible. Confirm your NEMT ride the day before your appointment and make sure you have the correct pick-up and drop-off times and locations. Be ready at least 15 minutes before your scheduled pick-up time. If you have any special needs or requests, such as a wheelchair or oxygen tank, let the broker know at the time of your booking.

If you have a preferred transportation provider who utilizes clean, company branded vehicles, and uniformed drivers, always request that provider for your future transportation needs.

Most importantly, if you encounter any problems with your NEMT transport, including a no-show or a late arrival, contact your NEMT broker immediately and seek an explanation and solution. They may be able to arrange another ride for you or reschedule your appointment. If you remain unhappy with the quality or safety of your NEMT service, you can file a complaint with your NEMT provider and your broker.


Remember, you have the right to receive NEMT services that meet your needs and expectations, and in many cases, the responsible payer has service expectations and star ratings that can either positively or negatively impact their Member Experience scores and predicate their continued future growth. (SN)

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