Why is it important to be compliant?
In every industry, there are specified guidelines and general practices that must be followed. Compliance with these regulations is essential to the success and integrity of any organization. Failure to comply with your state and federal guidelines can result in serious consequences for your business. In this article we’ll be focusing specifically on the NEMT industry; it’s important to fully understand the required data needed since it varies per state. The requirements in this industry can vary drastically, making it difficult to keep track. By adding a software solution into your NEMT business you’re able to easily track required information, thus alleviating some of these challenges.
Required data needs to be easily accessible…
The use of electronic recordkeeping in the NEMT industry is becoming more prevalent and, quite frankly, necessary. One of the main reasons a provider needs to keep validated records of all data is to protect themselves in case of being audited. The auditor needs to have access to verified information from each trip; trying to locate and assemble all your paper records is challenging if not impossible, and you miss out on many added benefits that technology can provide.
Required information could include any or all of the following:
- The Medicaid enrollee’s name and Medicaid ID number
- The date that transportation services were provided
- The pickup and drop-off addresses
- The time you arrived for pickup
- The time you arrived at the drop-off location
- Vehicle license plate number of the vehicle used for transportation
- The driver’s license number of the driver that provided transportation services
- Printed full name and signature of the driver providing the transport
- An attestation from the driver that the trip was completed
- Proof the vehicle belongs to the correct entity and the identification number matches the ownership papers
- A signature from the client confirming that transportation services were provided
- Preauthorization of coverage before beneficiary receives transportation
- A physician may need to authorize the need for beneficiary transportation
- May only want to know that the beneficiary’s location drop-off was to a medical appointment
- May expect the medical facility to phone in the medical transportation request before providing services
Some states may have qualifications for drivers such as:
- Limited number of points on their license
- Certified driver health
- Vehicle liability insurance
- Criminal background check
Before the technology was available to gather all of this information, everything had to be done manually. Manual processes, especially at a large scale, create many opportunities for human error. Whether information is inaccurate, incomplete, or even missing, the manual reporting and reviewing process is much more stressful.
The Audit Experience
At some point, your business may face a compliance audit. A compliance audit is a comprehensive review of an organization’s adherence to regulatory guidelines. This audit requires you to have a myriad of data from past activity. The point is to make sure that you provided exactly what you’ve billed for, with the correct drivers and vehicles. If you’re unable to produce the validated documentation, there can be many negative repercussions such as penalties, fines, or even prosecution. It’s crucial to take the time to learn what constitutes as fraud and abuse, and make sure you’re in compliance with all regulations.
Maintaining a consistently compliant internal audit trail is essential. You will be saving yourself from the wasted time and frustration in locating old information, and focus your and your employees’ efforts on more important things.
Working with a software that handles this process for you can get—and keep—you on a route to better business. Features within a software such as geotagging and automatic timestamping can provide the necessary data needed to prove compliance. This feature set can easily show your drivers’ exact pickup and drop-off the passenger exactly where they said they did, and at what times. By investing in such a software and properly implementing it, you’re assuring that your data collection follows all regulations, is up-to-date, and compliant.
When dealing with paper, it can be very easy for your driver to forget to gather specific pieces of information, like a signature from a passenger. In this case, the driver might be inclined to falsify the signature in order to avoid any possible repercussions with management for missing information. In this situation, you have no way of knowing if the signature or other information gathered for the trip is accurate. If you were to be audited, the falsified information could be easily identified and your company could be at risk.
Consider this same situation but instead of using a paper trail, everything was done using a software solution. This would completely prevent the opportunity to enter inaccurate information. A good NEMT software platform knows exactly what data is required for each individual trip, and allows the driver to easily view and capture this information. On top of this, software with mobile applications use geotagging and timestamping, which create an audit trail of every change or action that is made during the trip whether it was the number of stops the vehicle made or where the signature was captured and at what time. Fraud prevention is one of the biggest benefits of using the right software.
Ease your mind with the assurance of data accuracy
Giving your organization the confidence in compliance that software provides is invaluable. Investing in and correctly implementing your software can save you countless headaches by protecting yourself and your organization with honest, accurate, and verifiable data.
Taking the initiative to switch from manual data entry to streamlining it through a software is easier than you think. Many software providers offer full implementation assistance, training, and support to make it easy to transition to a new software solution so that you can focus on what matters most: serving your customers.