Non-Emergency Transportation Vendor Application

Form Template

To provide non-emergency transportation services, transportation providers can apply with the Non-Emergency Transportation Vendor Application app.

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Non-emergency transportation services take injured workers/patients to medical appointments when their physician declares it a medical necessity. Patients must get prior authorization, then transportation services can be arranged. To apply to be a provider of non-emergency medical transportation services, applicants must provide the following information: company information, name of contacts for the business, type of service provided (wheelchair, ambulatory, stretchers, ambulances, other), driver information, service area details, etc. The app also contains a short questionnaire for vendors to fill out.

Features
  • Signature Capture
  • 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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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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