Insurance Authorization: FAQ
Will any NEMT services require prior authorization?
Yes, when dealing with Insurance you always want to make sure you’re in the know of what is and isn’t covered. In Michigan, Medicaid MCOs are responsible for arranging NEMT. An estimated 74 million Americans currently rely on Medicaid to fund their health care, according to U.S. News and World Report. And many of them use non-emergency medical transportation (NEMT) to get to and from their appointments. For NEMT providers and the funding sources that broker these trips, settling reimbursement claims in a timely manner can quickly become complicated for several reasons:
Service-level agreements will vary by broker and provider, so contract management must be meticulous.
Billing rates vary based on type of service, level of service, time of day and other factors, meaning providers need to track working hours with precision.
Seamless integration between brokers and providers is needed to facilitate faster time-to-reimbursement.