As NEMT providers, it’s important to maintain credibility while also providing quality service. While there are a few bad apples committing fraudulent activities, the majority of providers are operating entirely above board. However, brokerages are taking fraud seriously, which means they are examining their clients with great scrutiny. In the area of reimbursements for mileage, brokerages will want to see an accurate accounting for every trip that you make.
Providing proof and evidence is essential for due diligence practices. This is why the power of NEMT software for reporting is so critical when it comes to providing detailed and accurate information on your operation. As well, an automated database can provide extra security to:
- Ensure that all drivers meet Medicaid standards
- All calls are valid
- All riders meet eligibility requirements
- All trip destinations are Medicaid-approved
What are Fraud Schemes?
An activity is considered fraudulent when a provider knowingly submits a Medicaid reimbursement claim when they are not entitled to one. Proving that a provider is operating in good faith may be up to the provider to produce the proof. This is where NEMT software with data collection and report generation tools come to the rescue. The Medicaid Fraud Control Unit describes three stand out areas where fraud is most prevalent:
- Billing for services not rendered
- Billing for more than actually performed
- False diagnosing
If you’re still using paper manifests, are you entirely confident that the data recorded is accurate? And are you equally as confident that the data will be perceived as accurate as it may have been jotted down in a hurry by a driver in the field?
NEMT Software for Accountability and Tracking
All data is recorded in real time and is synchronized with office NEMT software. You can customize fields in order to produce reports that detail the exact information you wish to highlight. Not only can providers witness possible violations as they occur, but they can also create reports that prove that they have acted with due diligence to prevent violations from occurring. Drivers can input data about trip details when they happen. This information can quickly be accessed by providers in order to prove: type of trip, disability type and specific service required. Because Momentm works with some of the major brokers, the two-way exchange of data has been optimized for the NEMT provider.
Driver and Rider Database Prevents Error
Drivers need to comply with Medicaid requirements and therefore their certification must be produced on demand if an audit or investigation happens. The same scrutiny is paid to riders who must be Medicaid-approved for transportation reimbursement. Because rider information is contained and viewable from a simple desktop application, schedulers can easily see if all the criteria are met in order to accept and book rides. This means that there is a reduction in errors at booking time, which greatly improves a provider’s credibility.
NEMT software is designed to increase efficiencies both in the office and in vehicles. But the reporting capabilities have the added benefit proving a provider’s credibility. Contact us today if you want to learn more about how software can help with eligibility and billing requirements.
