The NEMT industry is undergoing a digital transformation as technology quickly enables businesses to improve efficiency.
There are 68 million Medicaid beneficiaries in the US that NEMT businesses can potentially serve. This potential market size presents a considerable opportunity, albeit with significant operational challenges.
Non-emergency medical transport (NEMT) brokerages or Medicaid transport brokers of all sizes can use NEMT software, like Tobi Cloud, to increase operating efficiency and reduce costs. NEMT software also lets brokers quickly scale their business as they expand.
State Medicaid Authorities (SMA) are mandated to offer transportation for beneficiaries to and from healthcare providers. The SMA contracts a broker to manage these transportation services. Brokers act as liaisons between beneficiaries of the Medicaid program and vendor networks of NEMT vehicles and drivers.
Brokers need to verify that customers are eligible for Medicaid transport. Once beneficiary authorization for NEMT services is verified, brokers dispatch vehicles that belong to NEMT provider networks to pick up the customers and drop them back at their residences.
Brokers must also verify that all vehicles, personnel, and dispatching software they use match national standards and state compliance mandates. A one-page CMS newsletter covers the basics of compliance for NEMT brokerages.
This article looks at the top 5 benefits of NEMT software for brokers:
- It simplifies day-to-day operations.
- It streamlines trip management.
- It provides a single source of data.
- It fulfills compliance requirements.
- It enables business insights.
Brokers connect a vast number of beneficiaries to transport providers spread across the state. The matching and scheduling of rides is a highly complex process. Additionally, the volume of requests is not predictable, and a broker may experience a rush of orders that can be difficult to manage. NEMT software can help brokers simplify complex day-to-day business operations.
NEMT software for brokers can reduce manual work and save costs. It can also provide real-time updates for better coordination while using fewer human resources.
Scheduling automation saves time and resources by automatically matching drivers to NEMT transport members and assigning trips. With the right NEMT software, brokers can easily manage multiple transport providers across different states and quickly select among them for the journey.
Dispatching and Filing
Dispatching tasks comprise a significant portion of the day-to-day workflow that NEMT brokers handle. Manual dispatching is human resource intensive and consumes a considerable part of NEMT brokers’ workforce.
Automating NEMT dispatching is thus a significant advantage that NEMT software provides.
Filing and documentation is another recurring yet critical task that NEMT software streamlines. With electronic records, tracking and filing historical data becomes more manageable.
Driver credentialing and patient eligibility
Before assigning the trip, NEMT brokers must verify compliance information for patients and drivers that they match.
Driver credentialing includes criteria like:
- Valid driving licenses
- Other appropriate licenses (like a chauffeur’s license, required in some states)
- Medical fitness certificates
- Liability insurance
- Clean driving records
- Criminal background checks
NEMT software with an open API can communicate with central databases. It can continuously monitor these criteria in the background and flag any NEMT driver that does not meet them.
Before booking the trip, brokers must verify if Medicaid covers the customer for these services. Verifying patient eligibility ensures NEMT brokers don’t face difficulties later in claiming the trip cost from insurance companies.
Billing and claims
Digitized manifests make tracking trip info easier for compliance and historical data needs. Plus, with digital billing and trip attestation, filing claims and receiving payments from insurance companies becomes more straightforward.
Streamline Trip Management
Besides optimizing a broker’s overall business processes, NEMT broker software can also help improve the grassroots experience of the business. With built-in tools to monitor different aspects of each trip, NEMT software makes it easy to improve customer satisfaction.
NEMT software can help brokers track and monitor drivers in real time. The efficiency of drivers, the wait time, distance traveled with the customer, and trip attestation all give a picture of the driver’s interaction with the customer.
NEMT provider information
Different NEMT providers have different ways of working. Tracking and monitoring the NEMT providers with sizable fleets can help NEMT brokers quickly select the most suitable provider network.
Patient and vehicle information
Tracking the patient and vehicle information is also helpful in improving the customer experience. Being unable to match available vehicles to a patient’s specific accessibility needs when dispatching can result in trip delays or the patient’s inability to get into the vehicle.
Traditional NEMT brokers rely on self-reporting by NEMT drivers or transportation providers to track and verify trip data like drop-off locations, the route the driver took, on-time pick-up, or trip completion.
But NEMT software provides easy access to real-time trip data, which enables brokers to monitor drivers during the trip and ensure that customers accessing NEMT services receive the best experience possible.
Provide a Single Source of Data
For all modern businesses, data plays a critical role. Collecting, organizing, and accessing information is the first step modern digitized companies take to improve their processes.
Ensuring data availability is especially true in the healthcare industry because electronic healthcare data is usually proprietary or masked by compliance requirements. Brokers using HIPAA-compliant NEMT software can store and use patient data, which can be an invaluable resource.
To ensure exceptional customer service, storing patient data is critical for all NEMT businesses. Ensuring high customer satisfaction standards is part of the NEMT broker’s mandate.
Some patients accessing NEMT services have unique transportation needs that standard vehicles do not support. For example, brokers must provide wheelchair-accessible transport for customers with limited mobility. Knowing more about the customer’s needs can help brokers deliver better service.
Storing data about the driver can help NEMT brokers retain and monitor driver credentials. Verifying and updating driver credentials helps brokers meet federal, state, and corporate compliance requirements.
Retaining credentialing data allows brokers to assign drivers to each trip that matches the state’s compliance requirements.
NEMT provider data
Retaining NEMT provider data allows brokers to identify effective transportation partners.
Service history, vehicle data, and fleet quality of NEMT providers allow brokers to quickly identify the most suitable providers as soon as a customer initiates a booking.
The number of vehicles a provider can supply helps schedule and plan services, especially during peak demand intervals.
Insurance vendor data
Brokers deal with various insurers while delivering their services. These can be state-mandated insurance providers like Medicaid or commercial partners.
Each insurer may have specific rules and requirements for making claims. Keeping track of any unusual data or the attestation specific insurers require can help brokers ensure a smooth claims and payments process.
Fulfill Compliance Requirements
Brokers are contractors for a state’s Medicaid program. Brokers bid for this business in a competitive process. This contractual structure means the state will only use a specific broker to service a particular area.
Like any insurance provider, Medicaid has strict compliance norms, and brokers must stick to them. In addition, brokers must retain their NEMT transport data and be open to audits from the state when requested. NEMT software can automate this regulatory data collection and retention to make a broker’s job easier.
Ensuring that the credentials of transport staff are valid is explicitly stated as a compliance requirement by the state. Storing and monitoring the credentials of NEMT transport staff ensures compliance.
Verifying that drivers have a valid driving license and maintain a clean driving record is something that NEMT software with an open API can automate. NEMT software can also collect and store customer feedback after the ride, which can help brokers track how courteous drivers are.
Being able to store and utilize patient data to deliver better services is invaluable for NEMT brokers. However, there are compliance requirements that brokers must ensure before legally storing and accessing this data.
Compliance with the Health Insurance Portability and Accountability Act (HIPAA) is essential to carry out electronic transactions and store and access patient data. Thus, brokers must ensure that they only use HIPPA-compliant NEMT software.
Also, brokers must have procedures and processes to screen customer eligibility for state-backed Medicaid.
Brokers must maintain documentation of trips and services. States can request access to this data at any time for audits. Not documenting or providing this data when asked can incur hefty fines or even lead to the state barring the broker from providing NEMT services.
NEMT software can automate the reporting process. With electronic attestation, the software tracks the mandated forms to be filled in and captures all required documents and data once the trip is complete.
The standard documentation for trips should include:
- Beneficiary name
- Medicaid identifier
- Pick-up and drop-off locations
- Date and time of the services
- Distance traveled with the beneficiary
- Signature of the beneficiary
Enable Business Insights
One of the most significant impacts of using NEMT software is the insights brokers can gain into improving their business efficiency and saving money.
Leading NEMT software can help regularly produce high-quality reports for brokers to measure indicators of business efficiencies. These indicators can include the total number of trips, growth in revenue, operational expenses, etc.
NEMT software makes it easy to track and monitor the overall performance of drivers. Brokers can analyze a driver’s work efficiency patterns to determine if a driver is an asset to the business or causes the broker to lose money.
Standard metrics that measure NEMT driver efficiency are:
- Average trip time
- Beneficiary wait times
- Customer satisfaction scores
- Clean driving history
- Deviation from pre-set routes
Patient and insurance vendor reports
Knowing which patients tend to cancel appointments can help brokers assign trips better. Tracking patients no longer eligible for Medicaid is another way NEMT software can help improve business efficiency.
Similarly, tracking the behavior of private insurance vendors can help brokers expedite the claims process. Knowing the specific mandated forms and compliance requirements that insurers have can reduce the paperwork and follow-up required to collect payments.
NEMT software can also help track the condition of vehicles used for NEMT trips. Ensuring that the quality of automobiles NEMT providers use meets the customer’s requirements can help NEMT brokers comply with state regulations and ensure exceptional levels of customer satisfaction.
NEMT Software is an Essential Tool
For NEMT brokers, any tool that can automate routine processes and improve regulatory compliance is essential. Modern NEMT software can do even more.
Choosing Tobi Cloud NEMT software can save costs and reduce the compliance burden for brokers, and at the same time, help manage daily operations better.