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Title
Description
Enrollee Introduction Letter
NYS DOH introduction letter
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Definitions, Acronyms & Standards
Common terms, acronyms, criteria definitions, and standards used in Non-Emergency Medicaid Transportation
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Enrollee Responsibilities and Conduct
Rules and guidelines for using Non-Emergency Medicaid Transportation
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List of Essential Contacts
List of key Modivcare contacts
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Policy for Travel Related Expenses / Reimbursement Guide
Long Island Department of Health policy regarding travel related expenses for Medicaid Enrollees.
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Public Website Links
Internet links for key public services
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What to expect from your transportation provider.
NY State Expectations for Quality Transportation Services.
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Determining the Appropriate Type of Transportation
Utilization Review of Requests and Determining the Appropriate Type of Transportation
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What Modivcare is responsible for.
Describes ModivCare responsibilities for enrollees and how Medicaid enrollees can request transport.
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Mileage Reimbursement Forms
Form(s) that are required to be completed by the enrollee, the driver and the physician in order to receive mileage reimbursement.
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NYS DOH Care Plan Grid for Transportation of TBI Waiver Participants
Care Plan Grid required by NYS DOH to be submitted for Transportation of TBI Waiver Participants .
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Social Transportation Guidance for the Traumatic Brain Injury (TBI) Waiver Program
Guidelines for Approving Requests for Social Transportation of Persons Enrolled in the Traumatic Brain Injury (TBI) Waiver Program.
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2021 Mileage Reimbursement Schedule.
2021 Mileage Reimbursement Payment Schedule for Medicaid Enrollees
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Outside Common Medical Market Area Form
NYDOH .form necessary to approve trip requests Outside the Nassau and Suffolk Counties Medical Market Area
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