Can a non-emergency transportation provider contract directly with Texas Medicaid, i.e., the Texas Health & Human Services Commission?
A transportation provider must enroll through TMHP to appear on the Master Combined Provider file before the MTO can initiate their enrollment process and report on the MT88. After this is complete, the NEMT transportation providers must contract with LogistiCare. LogistiCare is the HHSC contracted Transportation Broker responsible for assigning and paying for Medicaid and CSHCN Non-Emergency Medical Transportation services for MTO Region 7.
What is the roll-out schedule for LogistiCare taking over management of non-emergency transportation for Texas HHSC’s MTO Region 7?
On August 1, 2014, LogistiCare will take over management for all non-emergency medical transportation services for Medicaid and CSHCN clients for trips occurring on or after September 1, 2014.
How will a transportation provider receive a trip manifest from LogistiCare?
Transportation providers will finalize an EDI Agreement with LogistiCare and thereafter download their trip manifests from http://www.txmedicaidride.net.
How can a transportation provider get in touch with LogistiCare?
Transportation provider should call LogistiCare’s toll free transportation provider number or fax to its toll free transportation provider fax number 877-564-9840.
Transportation Provider Phone Line
Can a non-emergency transportation provider transport Medicaid members without contacting LogistiCare?
No. NEMT transportation requests are preauthorized, assigned and paid for by LogistiCare.
When are the billing invoice form and trip logs due to the LogistiCare Claims Center?
Billing invoice forms and trip logs are due by the dates on the Texas Provider Payment Schedule for the current year.
How long does it take for my invoice or batch of trip logs to be process for payment?
Claims received by the invoice due date (see Texas Provider Payment Schedule) will be processed by the following check disbursement date shown on the schedule.
When are the checks mailed or funds deposited into my account?
Checks are mailed or payments are posted to your account on the check disbursement date indicated on the Transportation Provider Payment Schedule.
I did not receive a check or my Electronic Funds Transfer (EFT), what do I do?
Please allow a minimum of seven (7) business days from the date the check was disbursed before contacting the claims center. After you have allowed the minimum of seven days, please contact the claims center Monday through Friday between 8:00 a.m. and 5:00 p.m. at 877-564-9837. Only after seven business days will LogistiCare stop a payment and reissue a check. If you are using EFT, please allow twenty-four (24) hours for the monies to post to your account.
Why were my trips denied?
Trips can be denied for various reasons (invalid driver, no pick up time, no signature, no drop off time, no per trip billed amount, non-compliant vehicles/drivers, etc.) Denial reasons will be listed on the Transportation Provider Detail Report.
What does it mean if LogistiCare shows my trip was assigned to another provider?
The job number that you submitted is in LogistiCare’s system; however, it is assigned to another transportation provider. If you performed the trip, contact the Transportation Department at 855-693-2901 for resolution.
How do I sign up for direct deposit?
Contact the Austin Regional Office and request an EFT (Electronic Funds Transfer) form. Complete the form and return it via mail to the Austin Claims Center for processing.
How long does it take for direct deposit to become effective?
It normally takes 3-4 weeks to process and EFT application. If you decide to cancel your EFT, please complete another EFT form to cancel the transfer. This should be done 2-3 weeks prior to your next payment. Download the file or contact the Austin Regional Office and request an EFT form.
I submitted some trips, but I did not get paid for all of them. Why?
Please reconcile your invoice against the Batch Detail Report, there may be denied trips. If you feel a trip was denied in error or omitted, please resubmit the trip for processing. Please include a copy of your trip log and the resubmit form with your resubmission.
How do I resubmit trips for payment?
Resubmissions should be sent to the claims center with the trip logs and reason for resubmission. Complete the Resubmit Form. If you feel the information you submitted is accurate and need assistance making corrections, please contact the Austin Regional Office.
How do I get a new job number assigned?
The claims center does not and cannot assign trip numbers. Please contact the Austin Transportation Department and request assistance. They will research the request. You will receive notification of a new job number or denial.
My mileage is not correct, what should I do?
The claims center does not and cannot change mileage. Any mileage discrepancies will have to be discussed with the Austin Regional Office. Please refer to your Transportation Agreement regarding mileage. Mileage is calculated as the shortest distance in street or road miles from the pick-up point to the destination. If you believe there to be a mileage error, you must bring it to LogistiCare’s attention before running the trip. LogistiCare will review the trip or trips in question and may reference other software to verify the distance. Any correction remains the sole decision of LogistiCare. If you are not satisfied with LogistiCare’s decision regarding the mileage, you may reroute the trip. Performance of a trip constitutes acceptance of the mileage provided by LogistiCare.
Can I fax or email my billing invoice form and trip logs to the claims center?
No. Billing invoice forms and trip logs cannot be faxed or emailed. The original documents must be sent via USPS mail, FedEx, AUPS, etc. and must be received by 5:00 p.m. EST on or before the “Invoice Due to Claims Center” date.
My rates are not correct, what do I do?
The claims center pays according to rates that are in the Transportation Agreement between the transportation provider and LogistiCare. In the event you feel your rates are incorrect, please contact the Austin Regional Manager immediately.
My claim was denied because the vehicle and/or driver are invalid, what does this mean?
Invalid driver/vehicle means that your driver/vehicle is not compliant with the requirements of the Transportation Agreement. Contact the Austin Regional Manager and the Compliance Specialist Team immediately.
Am I required to attach an invoice report form to my daily trip logs?
Yes, billing invoice forms are required to be submitted with all original daily trip logs.
Where do I mail my invoice form and daily trip logs?
LogistiCare Claims Center
12234 N I-35, Plaza 35, Bldg. B, Ste. 175
Austin, TX 78753
What is the contact information for LogistiCare’s Texas Claims Center?
You can email the LogistiCare Texas Claims Center at firstname.lastname@example.org You can also call the Claims Manager at 877-564-9832 x 2013 or the Billing line 877-564-9837.
If there is a complaint about my company, driver or vehicle from a rider of medical provider, will I have an opportunity to respond?
Yes. Responses to complaints are due within 24 hours of when the transportation provider receives the complaint from LogistiCare.
What are the pick-up and drop-off standards?
The pick-up standard for a routine and standing order trip is not earlier than 15 minutes before or later than 15 minutes after the scheduled pick-up time. There is a 60 minutes (1 hour) pick-up standard on a “will call” or unscheduled return to residence following a medical appointment. The pick-up standard for an urgent care request (e.g., a hospital discharge) is within 180 minutes (3 hours) from when LGTC gets the request from the hospital and communicates it to you. The drop-off standard is on-time or early however not more than 30 minutes before the client’s appointment.
Can a provider of wheelchair services refuse to transport a client at the point of pick-up if the client’s wheelchair or other conveyance cannot be properly secured?
Can a transportation provider request transport on behalf of a client?
Can a transportation provider provide a list of its regular, standing order riders to LogistiCare in an Excel file?
Yes. However, this list will only be used for provider preferences the clients might have but never for making reservations on the client’s behalf.