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Non-Emergency Transportation Services Prior Approval Program

Non-Emergency Transportation Services Prior Approval Program

First Transit

Medical appointment transportation for patients with Medicaid.

Services Offered

Medicaid • Medical Transportation

Description

NETSPAP helps Medicaid recipients arrange transportation to and from medical appointments. First Transit reviews prior authorizations for non-emergency transportation. In order to be approved for Non-Emergency Transportation services, the Participant must be transported to an appointment where they will receive a covered medical service. A covered medical service is a Medicaid Eligible Medical Service (MEMS).

Covered Services include:

  • Chemotherapy
  • Radiation
  • Wellness exam, or annual physical exam
  • Glaucoma, Cataracts
  • X-Rays, MRI, CAT scan, or other diagnostic testing
  • Blood test
  • Hospital admit or discharge
  • Sleep study
  • Outpatient surgery
  • IV infusion
  • Birth control
  • Prenatal care
  • Gastrointestinal problems

Covered with limitations:

  • Emergency room (ER) transports
  • Prosthetic device fitting
  • Prosthetic device pick-up
  • Diabetic teaching; dietician or nutritionist visit
  • Flu shots/vaccinations
  • WIC
  • Abortion services
  • LTC admit or discharge
  • Hospital to hospital transports
  • Wheelchair fitting
  • Wheelchair pick-up
  • Eye glass fitting and pick-up
  • Group behavioral health services
  • Tobacco cessation counseling services

For more details on covered and non-covered services, see manual webpage.

Location

799 Roosevelt Rd., Bldg 4 Ste 200, Glen Ellyn, IL 60137 41.8579536 -88.05472

Service Options

Languages Spoken

  • English
  • Spanish

Eligibility

  • The Participant must have Medicaid eligibility on the Date of Service
  • The Participant must be traveling to a scheduled medical appointment (not shopping, or to work)
  • The Participant must have no other way to get to their medical appointment ( no access to cost-free modes of Non-Emergency Transportation)
  • The Participant must be transported in the least expensive mode of Non-Emergency Transportation, referred to at times as Category of Service (COS), that can safely transport the Participant on the Date of Service, and if appropriate, approved with an employee or non-employee attendant.
  • The Participant must be transported by a NET Provider enrolled for the appropriate COS.
  • The Participant must be transported to the closest appropriate provider.
  • The Participant must be receiving a covered medical service.

    Payment

  • Medicaid accepted

How to Apply

Medicaid clients may call 877-725-0569 to schedule an appointment or request through PassPORT and in order to set up an account.

It is recommended to make transportation reservations as far in advance as possible. You or the person calling for you will need to:

  1. Call a transportation company to see if they can take you to your doctor’s appointment. You can call the transportation company you always use (or) If you need help finding a transportation company you can call First Transit at 1-877-725-0569.

  2. Call First Transit at 1-877-725-0569 to get your trip approved. First Transit will ask:

  • Your name
  • May need to get your “OK” to talk with the person calling for you
  • Your pick-up address and phone number
  • Your Medicaid ID# (9 digit recipient identification number)
  • The general reason for your doctor’s visit
  • The name of the office/clinic /hospital where you are going
  • The name of the doctor you will be seeing
  • The address and phone number where you are going
  • The appointment date and time
  • If there are medical or non-medical reasons why you can not use public or other transportation
  • If you use a walker, wheelchair, or cane
  • If you can travel by yourself

First Transit will give you a reference number.

  1. Call the transportation company and give them your reference number and schedule your pick-up time.

  2. Call the transportation company before your doctor’s appointment to confirm your reservation.