Medicaid Transportation Unit

DNNDMZQualSU posted on March 02, 2009 11:18

(NET) is a ride or reimbursement for a ride, provided so a Medicaid participant with no other transportation resource can receive necessary medical care or treatment provided at a scheduled appointment.

The services must be covered by Idaho Medicaid. Neither commercial or agency transportation is authorized for persons owning (or having access to) a functioning personal vehicle. Refer to IDAPA Rules governing transportation.

Beginning November 14, 2005, we will ask that you direct your requests for prior-authorization in the following manner.

For transportation to developmental disability and mental health services, contact:

Dori Boyle, locally at: (208) 287-1172 OR long distance at: (800) 296-0509 # 1172.

BoyleD@dhw.idaho.gov FAX number: (208) 334-4979 or (800) 296-0513

For transportation to all other non-emergent medical transportation requests and out-of-state transportation contact:

Sara Stith, locally at: (208) 287-1173 OR long distance at: (800) 296-0509 # 1173.

StithS@dhw.idaho.gov FAX number: (208) 334-4979 or (800) 296-0513

Only the least expensive, most appropriate and available means of transport may be prior approved after all free resources have been exhausted.

Although clients may choose their provider of Medicaid services, appropriate transport is authorized only to the closest, appropriate and available provider.

Clients are responsible for transport beyond the closest provider when they choose an out-of-area provider for their service.

Expediting PA Process

1. Provide a minimum 24-hour notice prior to appointment time.

2. Identify the Medicaid covered service.

3. Ensure closest available service.

4. Calculate one-way miles and cost per unit prior to request and allow for holidays.

5. Submit all requests in the readable/standardized request form.

Reconsideration by MTU prior to requesting a Fair Hearing. See Provider Handbook. Contact EDS at 383-4310 or 1-800-685-3757 regarding Provider Enrollment or questions on claims submission.

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Medicaid Transportation Unit

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