Fee-For-Service Non-Emergency Medical Transportation Brokerprovider.indianamedicaid.com/media/215903/southeastrans.pdf · Fee-For-Service Non-Emergency Medical Transportation Broker
Post on 05-Jun-2018
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• Our Experience
• Corporate Structure
• Provider Network
• Provider Partnership
• Training & Compliance
• Provider Credentialing Process
• NET InSight Mobile Technology
• Member Care Technology
• The Mobile Advantage (Claims)
• Q & A SessionSoutheastrans Confidential Material 2
Overview
• Medical transportation experience since 1974
• 17 Years as Medicaid NEMT Broker
• Operations in 5 states and the District of Columbia
• 2.3 million covered members
• 3.6 million trips annually
• 462 contracted NEMT Providers with 3500 drivers and vehicles
Southeastrans Confidential Material 3
Our Experience
• Executive Management
• Management & Operations
• Call Centers
• Dispatch
• Compliance
• Quality Assurance
• Claims
• Internal Audit
• Information Technology
• Training
• Provider Relations
Southeastrans Confidential Material 4
Corporate Structure
Our Executive Leadership Team
• Steve Adams – Chief Executive Officer
• Rob Zachrich – Chief Operating Officer
• Benjie Alexander – Chief Administrative Officer
• Jim Degliumberto – Chief Information Officer
• Gary Kinard – Chief Financial Officer
• Cathy Missildine – Chief Human Resources Officer
Southeastrans Confidential Material 5
Corporate Structure
Southeastrans Confidential Material 6
Provider Network
• Southeastrans currently contracts with more than 462 independent NEMT Providers
• Uses a comprehensive methodology for recruiting, credentialing, and training
• Our negotiations with NEMT providers are conducted on the principles of fairness and honesty
Southeastrans Confidential Material 8
Provider Network
Provider Partnership:• Regular provider meetings• Financial assistance when appropriate, such as fuel card program and auto
purchase.• Business and technical assistance, including: budgeting, routing, financial
analysis etc.• Weekly reimbursement• Provider portal, NET Notes and iPads provided at no cost to the provider• A culture of being “provider friendly” based on trust, integrity, and respect.• Must be enrolled as an IHCP provider prior to credentialing with
Southeastrans.
Compliance
• Credentialing of Providers and Drivers
• Digital vehicle inspections withphotographs
• Database link to vehicle tag numbers
• Field Integrity Unit
• Knowledgebase via the Provider Portal
Southeastrans Confidential Material 9
Training and Compliance
NEMT Driver Training• Community Transportation Association
of America (CTAA) Certified Trainers• Customer Service Emphasis and
HIPAA Awareness• Passenger Assistance, Safety and
Sensitivity(PASS)• First Aid/CPR/AED• Defensive Driving• Wheelchair and Stretcher Securement• Mobile Technology Training• NET Notes Southeastrans Confidential Material 10
Training and Compliance
Southeastrans Confidential Material 11
NET InSight™ Mobile App
“One of Georgia’s two NET brokers has
made innovative use of technology by
distributing mobile mini-tablets with
customized proprietary software to all
assigned drivers. The software enhances
the contractors’ ability to detect, deter,
and prevent fraud activities within the
broker’s contracted coverage area.”
2014 Georgia Medicaid Comprehensive
Program Integrity Review
Southeastrans Confidential Material 12
NET Notes
• GPS Enabled Messaging App
• Fleet Optimization
• Real-Time Beneficiary Data
• Traffic and Weather Updates
Southeastrans Confidential Material 13
Member Care Technology
A means for NEMT drivers to report concerns identified:
abuse environmental self-neglect vulnerability
Notifications are sent to the appropriate parties for further intervention.
Identifying people for intervention through services that may assist in improving their well-being and reducing the need for emergency intervention
Push Member messaging Import Client or
Southeastrans content Member reviews and
acknowledges message Digital signature capture
technology
Southeastrans Confidential Material 14
Southeastrans Confidential Material 15
The Mobile Advantage (Claims)
• Using iPads will reduce the number of denials codes/denied claims
• Claims are submitted daily and providers are paid weekly
• No more mailing and making copies of paper claims
• Ease of operation
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