Non-Emergent Medical Transportation (NEMT)

Non-Emergent Medical Transportation (NEMT) is a Health First Colorado benefit for members who don't have transportation to medical appointments. NEMT is currently  provided through one transportation broker, IntelliRide. The statewide brokerage will end on Aug. 1, 2021, and IntelliRide will reduce its NEMT service area to its original nine-county region: Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer, and Weld Counties. NEMT service in the counties outside of IntelliRide’s nine-county region will return to local transportation providers effective Aug. 1, 2021. Check out the NEMT Service Area resource guide to find out what counties are affected.

Here’s what Health First Colorado members, NEMT providers, and counties need to know. Health First Colorado members can also find out more by visiting the Health First Colorado NEMT webpage.

Frequently Asked Questions for Health First Colorado Members

Why is this transition happening?
Last July, the Department of Health Care Policy & Financing (the Department) expanded its contract with IntelliRide to manage all NEMT trip referrals, scheduling, and claims submission throughout the state. Local transportation providers and Health First Colorado members expressed concerns about the statewide approach shortly after its July 2020 implementation. The Department evaluated the feedback with IntelliRide and decided to restore the relationship between members and their local community transportation providers for those members outside IntelliRide's original nine-county service area. As a result, IntelliRide will no longer serve as the statewide broker for NEMT services effective Aug. 1, 2021.

What are the nine counties that IntelliRide will continue covering?
Effective Aug. 1, 2021,
IntelliRide's service area will contract back to its original nine-county region: Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer, and Weld Counties. There will be no operational or process change for transportation providers and members in IntelliRide’s nine-county service region. Learn more about the change in NEMT service areas

What happens to NEMT service coverage in the 55 counties outside of IntelliRide’s service area?
NEMT service in the 55 counties outside of IntelliRide’s nine-county region will return to local transportation providers effective Aug. 1, 2021. At that time, IntelliRide will no longer transfer NEMT trip requests for Health First Colorado members residing in any of the 55 counties outside of IntelliRide’s service area. These members must contact a local transportation provider directly (rather than IntelliRide) to schedule a trip August 1 forward. IntelliRide’s self-service and mobile booking will also no longer be available to members living outside of IntelliRide’s nine-county service region. Learn more about the change in NEMT service areas

IntelliRide, however, will still process mileage reimbursement claims for all Health First Colorado members, no matter where they live in Colorado. IntelliRide will also continue scheduling air, train, and out-of-state travel for members statewide. Contact IntelliRide at 303-398-2155 or 855-489-4999, or visit gointelliride.com/colorado for more information.

What should I do if I need a ride?
If you live in IntelliRide’s nine-county service area, continue contacting IntelliRide to schedule transportation 48 hours before travel. Call 303-398-2155 or 855-489-4999, or chat (gointelliride.com/colorado). IntellRide will verify basic info (state ID, name, address, etc.), check eligibility, and ensure that the destination is an enrolled location and that the trip is for a Medicaid-covered service.

If you live outside of IntelliRide’s service area, visit the NEMT provider page to find a local NEMT provider and contact the provider’s office directly to schedule rides for travel Aug. 1 forward. (Be sure to schedule travel at least two business days before your appointment.) The transportation provider will manage the administrative details including eligibility and authorization before dispatching the trip.

What happens if I already have a ride booked through IntelliRide for travel Aug. 1 forward?
Requests made in July for rides in August forward will be honored by the transportation provider IntelliRide assigned at the time the trip was scheduled. The transportation providers will have to honor the trip referral and provide service to the member.

Will the mileage reimbursement process change?
No, IntelliRide will continue to manage the mileage reimbursement process for all members, no matter the member’s county of residence.
Contact IntelliRide at 303-398-2155 or https://gointelliride.com/colorado/ if you are requesting mileage reimbursement or out-of-state transportation.

What is the process for booking out-of-state travel requests?
IntelliRide will continue to manage out-of-state travel requests regardless of the member’s county of residence.

How will meals and lodging requests be handled?
IntelliRide will continue to manage meals and lodging requests regardless of the member’s county of residence. These requests will be prior-authorized and reimbursed by IntelliRide statewide.

What if I have a problem with my transportation after Aug. 1?
Beginning Aug. 1, if you live outside of IntelliRide’s nine-county service area and you have questions about upcoming transportation, you must contact the local transportation provider selected at the time of service booking. This includes calls to let a driver know you are ready for pick up, calls asking about the estimated arrival time, calls to report a missed transportation, and any other concerns about service.

Will Dialysis and group subscriptions be transferred? 
No. Due to the volume of subscription services and the new method of allowing the member to select their own transportation provider, all members or facilities on their behalf must contact a transportation provider directly to arrange transportation including establishing a new subscription. These new subscriptions will begin August 1. Prior to August 1 all subscriptions will continue under IntelliRide authorization to avoid duplication of services. Find and contact a NEMT provider in your community.

Will Medical Necessity Forms (MNF) be transferred? 
No. Due to the volume of MNF forms and the new method of allowing the member to select their own transportation provider, members must submit the documentation required by their transportation provider to verify the medical necessity of their requested level of service.

For Transportation Providers

Effective Aug. 1, 2021, IntelliRide will no longer transfer NEMT trip requests for Health First Colorado members living in one of the 55 counties outside of IntelliRide’s nine-county service area. Local transportation providers outside of IntelliRide’s service area will be responsible for the following effective Aug. 1, 2021:

  • Verifying member and medical provider eligibility for trip requests beginning with the date of service Aug. 1, 2021.
  • Verifying and retaining documentation of medical necessity for level of service authorization for trip requests beginning with the date of service Aug. 1, 2021.
  • Submitting reimbursement requests to Gainwell for trips with a date of service beginning July 1, 2021.
     

Per IntelliRide, if transportation providers have a referral in the portal for a trip Aug. 1 forward, they do not have to clear it, but they do have to honor the referral and provide service to the member. Please see the billing and training manuals for more information. Updates will be communicated in provider blasts.

Frequently Asked Questions for Transportation Providers

Why is Colorado ending the statewide broker for NEMT?
Last July, the Department expanded its contract with IntelliRide to manage all NEMT trip referrals, scheduling, and claims submission throughout the state. Local transportation providers and Health First Colorado members expressed concerns about the statewide approach shortly after its July 2020 implementation. The Department evaluated the feedback with IntelliRide and decided to restore the relationship between members and their local community transportation providers for those members outside IntelliRide's original nine-county service area. As a result, IntelliRide will no longer serve as the statewide broker for NEMT services effective Aug. 1, 2021.

What happens on Aug. 1, 2021?
Effective Aug. 1, 2021, IntelliRide will no longer transfer NEMT trip requests for Health First Colorado members living in one of the 55 counties outside of IntelliRide’s nine-county service area. NEMT service will return to local transportation providers, and affected Health First Colorado members need to contact a NEMT provider in their community.

I joined the IntelliRide network, but I will now be out of their service region effective Aug. 1, 2021. What do I need to do?
Local transportation providers outside of IntelliRide’s nine-county service area will be responsible for the following effective Aug. 1, 2021:

  • Verifying member and medical provider eligibility for trip requests beginning with the date of service Aug. 1, 2021.
  • Verifying and retaining documentation of medical necessity for level of service authorization for trip requests beginning with the date of service Aug. 1, 2021.
  • If transportation providers have a referral in IntelliRide’s portal for a trip Aug. 1 forward, they do not have to clear it, but they do have to honor the referral and provide service to the member.
  • Submission of reimbursement requests to Gainwell for trips with a date of service beginning  July 1, 2021.

I will not be an IntelliRide provider in August, but I already have trips scheduled for members in August. What should I do?
If transportation providers have a referral in the portal for a trip Aug. 1 forward, they do not have to clear it, but they do have to honor the referral and provide service.

Why can’t I start a subscription from a member before Aug. 1? 
As IntelliRide will not know what subscriptions members have called in, the company will continue to refer these subscription trips to transportation providers through July 31. Starting a subscription before Aug. 1may result in duplicate services. If you provide service to a member who has already received the same service from another provider on that date of service, the Department cannot reimburse you for this service. In order to ensure compliance with state and federal guidelines, the Department cannot allow exceptions to this practice.

Where should I submit billing for services I provide in July?
Effective July 1, 2021, per the provider bulletin sent to transportation providers on June 29, transportation providers must submit reimbursement requests to Gainwell Technologies for all trips.

Where should I submit billing for services provided beginning Aug.1?
Transportation providers must submit reimbursement requests to Gainwell Technologies for all trips. Visit the Provider Contacts web page or call 1-844-235- 2387.

How can I learn about checking eligibility?
Transportation providers can check a member’s eligibility either through the provider web portal, the IVR system through 1-844-235-2387, or by submitting a batch 270.

For Counties

The Department provided counties with a list of local transportation providers to support and guide members when they call county offices to ask about NEMT service. (The list is also available on the Health First Colorado NEMT webpage.) Additionally, counties will no longer be involved in processing mileage reimbursement claims IntelliRide will continue to manage the process. Updates about the transition will be included in County Connections, a monthly Department newsletter that provides Department updates to county partners.

Frequently Asked Questions for Counties

What will be the county offices of health and human services’ responsibilities after Aug. 1, 2021?
Counties will not be required to take on additional work for this transition of NEMT services. However, the Department will provide counties a list of local transportation providers to support members when they call county offices. Visit the NEMT provider page to find the list and download the NEMT Service Area resource guide.

Will the counties need to process mileage reimbursement claims?
Counties will no longer be involved in processing mileage reimbursement claims. Instead, IntelliRide will continue to manage the mileage reimbursement process for all members, no matter what county they live in. If members contact a county requesting reimbursement, please direct them to a local transportation provider located at http://hcpf.colorado.gov/nemtlist.

What to know about non-emergent medical transportation and COVID-19

Only one person per vehicle traveling to an appointment is allowed. Health First Colorado members may bring a family member or caretaker to their appointment. When members call for transportation, they must let them know if they want to bring a family member or caretaker.

NEMT is not for emergencies. Members need to call 911 for medical emergencies.

If members are having COVID-19 symptoms, they must call their health care provider and let them know before using transportation or going to their provider’s office. A member’s provider may need to talk to them about their symptoms before their scheduled visit.

Transportation Providers: Please read Operational Memo HCPF OM 20-055 for Department guidance about preventing the spread of COVID-19.