NEMT Services
Billing & Claims
NEMT billing is mostly matching: each completed trip has to agree with the trip log, the signature, the mileage and any prior authorization before a broker or Medicaid payer will pay it. We prepare and submit claims, reconcile payments, work denials and show you what is still outstanding.
At a glance
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Pricing
Usually a percentage of collections or a fee per claim.
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Getting started
Billing usually starts from your next billing cycle.
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Coverage
Businesses across the United States
Who it's for
Built for businesses like yours
- Operators with unpaid or denied claims piling up
- Owners doing billing late at night
- Companies billing several brokers plus private-pay and facility accounts
What you get
Included in Billing & Claims
- Trips matched to trip logs and signatures before billing
- Correct HCPCS codes and modifiers for level of service and mileage
- Claims submitted within each broker's or payer's filing deadline
- Denials investigated, corrected and resubmitted
- Remittances reconciled against completed trips
- Short payments and missing trips raised with the broker
- Private-pay and facility invoices sent on schedule
- Monthly report of billed, paid, pending and denied amounts
Tools and platforms we work with
- Broker billing portals
- Clearinghouses
- QuickBooks
- Your dispatch software exports
- Excel and Google Sheets
How it works
Everything handled properly
Pre-billing checks
Trips are checked against trip logs, signatures, mileage and authorizations before anything is submitted.
Timely filing
Claims go out every billing cycle, well inside each payer's filing limit.
Denial work
Rejections and denials are sorted by reason, corrected, then resubmitted or appealed.
Payment reconciliation
Remittances matched trip by trip, so short and missing payments are caught.
Aging and revenue reports
Billed, paid, pending and denied amounts by broker, payer and month.
Private-pay and facility invoicing
Facilities and private-pay riders invoiced on the terms you set.
A day on the desk
From the first pickup to the last drop-off.
This is how a typical day is covered for a US operator. Hours and tasks are always agreed with you.
- Day before Tomorrow's schedule built Broker trips imported and checked, standing orders confirmed and drivers assigned.
- Early morning First dialysis pickups Drivers confirmed on the road and late starts caught before they become missed trips.
- Midday Will-call returns and changes Clinics call for returns, trips are reassigned and patients receive updates.
- Afternoon Broker statuses and new trips Portal statuses updated and new trips accepted for the days ahead.
- End of day Last drop-off and daily report Completed, late and canceled trips summarized in your inbox.
The details that matter before you start
No new software to buy and no long contract. We work inside the tools you already use.
- Coverage
- Early morning ET to late evening PT, weekends available
- Software
- Your dispatch platform and broker portals
- Patient data
- Business Associate Agreement and HIPAA training for every agent
- Pricing
- Per agent hour, per trip or a fixed monthly fee
- Most operators start with
- Dispatch and call handling
Coverage built around your shifts
Coverage can be arranged from the first dialysis pickup on the East Coast to the last will-call return on the West Coast.
HIPAA safeguards from day one
We sign a Business Associate Agreement before we see any trip data. Agents assigned to your account complete HIPAA training before go-live and get individual logins with minimum-necessary access.
Your software, your portals
RouteGenie, Tripmaster, NEMT Cloud or a broker's own portal. We log in to the tools you already pay for.
Records that hold up in an audit
Trip logs, signatures and status timestamps are kept the way brokers and state reviewers expect to see them.
Room for another broker contract
Take on more trips without adding desks, payroll or weeks of dispatcher training.
How we start
From first call to running smoothly
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01
Discovery call
We learn your fleet size, levels of service, service area, brokers, software and where your office is stretched thin.
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02
BAA and access
We sign a BAA, set up individual logins to your portals and dispatch software, and agree escalation rules and on-call contacts.
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03
Shadowing and go-live
Agents shadow your dispatchers first, then take over shift by shift so no trips drop during the handover.
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04
Daily operations and reporting
We run the desk every day and report on trips, calls, on-time performance, no-shows and claims.
Usually as a percentage of collections or a fee per claim. We recommend a model after reviewing your volume and payer mix.
Often, yes. We review the backlog, separate what is still inside the payer's filing window from what is not, and resubmit where the payer allows it.
Both, depending on how you are paid. Broker trips are normally billed through the broker's portal. If you also bill a state Medicaid program or managed care plan directly, we submit through the clearinghouse or payer portal you use.
No. We work inside your existing dispatch software and broker portals. If you do not have dispatch software yet, we can walk you through the options before you commit.
We sign a Business Associate Agreement before any access is granted. Agents assigned to your account complete HIPAA training before go-live, use individual logins with minimum-necessary access, and never store patient data on personal devices.
More NEMT services
All NEMT ServicesDispatch & Scheduling
Trip scheduling, driver assignment and live dispatch for NEMT fleets, handled by dispatchers working inside your software.
Learn moreCall Handling
Professional answering for patients, facilities, drivers and brokers, so every ride request, change and question is handled.
Learn moreBroker Trip Management
We monitor your broker portals, accept the right trips, keep statuses current and protect your broker performance scores.
Learn moreCredentialing
Broker enrollment, document management and renewal tracking so your NEMT company stays approved and ready for trips.
Learn moreNEMT Marketing
Websites, Google visibility and facility outreach that help NEMT companies win direct trips and depend less on brokers.
Learn moreStart a conversation
Get a quote for Billing & Claims.
We reply within one business day with next steps and a clear written quote.