Brokers are at the very center of the NEMT industry. Brokers connect NEMT providers with patients who are eligible for Medicaid Insurance programs.
It may seem simple, but it's a hefty task to do because of so much involved in the procedure, from receiving trips requests making sure that person is eligible for Medicaid insurance, and then assigning that trip to the NEMT provider and making sure that their vehicle fulfills the requirement of the patient.
State Medicaid Agencies (SAMs) are authorized to establish a NEMT service through a NEMT broker. SAMs select their brokers through a competitive bidding process.
NEMT brokers must comply with referral and conflict-of-interest regulations and be subject to regular SMA audits.
Here is a complete blueprint of how a NEMT broker works daily:
1. A member or caretaker contacts the broker and tells them they want a trip to a medical facility for their appointment; they can contact the broker through phone, app, internet, etc.
2. Broker then identifies the health plan or insurance that the patient is part of. Also, the broker verifies the level of services that which patient requires, such as ambulance, wheelchair, stretcher, etc.
3. Then, the broker will have to assign the trip to the NEMT provider working in that area while ensuring that the NEMT provider fulfills the patient's requirements.
Although these are the main tasks a broker will perform daily, some other important things are necessary for a NEMT broker business to run, like invoicing and billing, importing and exporting trip/driver logs, and managing different schedules.
If you want to become a NEMT broker, you first have to understand where a broker is placed in the chain of the NEMT industry. Broker first gets trips from State Medicaid Agencies
( SAMs ). Then after getting a trip request from a patient, they assign it to local NEMT providers.
You have to contact state or local Medicaid agencies to get contracts. You can also reach out to hospitals or private doctors to start small. These contracts will be small, but they will help you create. As you gain experience and reputation, you can get contracts from large Medicaid Agencies.
The second step you have to take is to establish contact with local NEMT providers so that when you get a trip, you can easily assign it to them.
You may need to sign contracts with whom you are working. Also, it would be best if you had a database to collect all the information about the firms you work with and the terms of cooperation.
Advancements in technology have revolutionized almost all industries in the world, so how can NEMT Brokerages be left behind?
The old-school way for NEMT brokers involved call centers and many employees. When patients needed a ride, they had to contact the call center of NEMT brokers. Then the broker had to manually verify the patients' healthcare plan and the level of services they needed, i.e. wheelchair, stretcher, etc.
After verifying broker had to call the local NEMT provider to assign the trip, this process involved massive inconvenience for patients and brokers. Late arrivals and miscommunication were common.
After the emergence of NEMT broker software, the tasks of brokers have become a lot easier, and their efficiency has increased drastically. Now the patient can quickly request a ride through their phone on a mobile app, and the NEMT broker software automatically verifies the patient's healthcare plan.
NEMT brokers and providers make communication easier through NEMT Software; they can easily import/export trip data and create invoices and claims.
Becoming a NEMT broker is not enough; you must be the best in your industry to stand out and acquire more prominent clients.
To achieve what others won't, you have to do what others don't. I am not talking about just.
Working hard; to grow fast, you have to work smart.
Having a goal about where you want to see your business in the coming time will help you set a proper direction for your employees and yourself. Most importantly, you can always measure your success. This is the fastest way of growing your business.
Conducting regular audits and analyzing your business shows you where you lack, and that there is room for improvement. It's good for you to perform these audits 2 to 3 times a year.
Don't hesitate to automate your day-to-day business tasks with NEMT Broker software. If you don't use this software, you will have to employ a lot of staff to complete your daily tasks. Human error is more likely to occur, and your overall efficiency will be reduced.
As the older population is becoming larger, the need for healthcare for them is also rising, and someone is required to pick and drop them to their desired positions. That's why the NEMT industry is continuously growing, and there are no signs of stopping.
So, it's a good idea to start now and let the boom in the industry take your business with it