Non-Medical Transportation Service Provider Certification Form

Form Template

As part of the Medicaid program, patients may be eligible for non-emergency, non-medical transportation services for medical appointments.

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The Non-Medical Transportation Service Provider Certification Form app allows transportation service providers to apply for certification to provide non-emergency transportation to patients. The provider agency must maintain documentation that the company meets the required criteria and standards for the Non-Medical Transportation service; and have records available to complete quality review audits. Within the Non-Medical Transportation Service Provider Certification Form app, providers must supply the following details for certification: service program information, provider type documentation, clinical documentation, other standards documentation, training documentation, and miscellaneous documentation.

Features
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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