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How to Choose an NEMT Software - BuiltByBits

Introduction

If you work in the transportation industry, particularly the Non-Emergency Medical Transportation (NEMT) segment, there are a lot of software systems out there that may make your day-to-day operations easier, faster and more efficient. But not all of these software systems offer the same benefits, and not every transporter has the same needs. If you’re looking to switch from paper records to a software system, or you’re not happy with your current software and are looking to avoid repeated mistakes, it can seem overwhelming to vet all your options and make the right choice.

When it comes to choosing the right NEMT software for your business, it’s important to know what’s available, and what questions to ask. Let’s break down some of the most beneficial features, and how they can help you streamline your business.

The Big Three: Routing, Billing, Trip Management.

Typically, when people go on the hunt for an NEMT software system, there are three main things they’re looking for help with:

  1. Routing
  2. Billing
  3. Trip Management

These are huge. Without solid management of these three areas, your business can’t function – at least not well. Nearly every software solution on the market offers some kind of assistance in these areas, so let’s look at these more closely.

Routing

Every day, you need to put together a schedule that matches your drivers with requested trips. Ideally, you do this in a way that maximizes each driver’s time and allows you to complete as many trips as possible in a given timeframe. What if you had a button that just allowed you to push “best route” and auto-assign drivers?

While in theory that sounds like a great solution, it might not be the best solution for your business. For one, each company, broker, trip and software developer may have a different idea of what “best” means. Customers may have special needs or requests to be taken into consideration. You may have specific geography challenges, or a service area that differs from what the developers imagined. What about multiloading? Sometimes it’s a great efficiency optimizer, but sometimes it’s an unnecessary burden. You may see a lot of software providers touting a “best route” button. But you don’t need a software that tells you what the best route is – you need a software that keeps you in control of what’s “best,” and makes assignment suggestions based on that criteria. You need a routing solution that maximizes efficiency while saving you time.

Billing

Billing and reimbursements can take up an enormous amount of manpower and bandwidth. Generating the proper files required involves collecting the right information from each trip, assigning rates and codes, compiling it into a CMS-1500 or other appropriate form, and submitting to the broker or correct state department. In the complex world of NEMT billing, successfully fulfilling each requirement for billing can feel like a moving target, with so many variables affecting each trip.

Some software systems can automatically assign rates and billing codes to trips based on the proper factors, which can save you hours of work each week and eliminate the inevitability of human error. Software that generates billing forms may not be enough. Ideally, a software system that integrates appropriately with brokers and makes data collection and input easy is a better solution than one that simply generates forms.

Trip Management

Every provider has different kinds of trips from different sources. Some work with insurance companies or health plans directly. Others work with medical facilities or school districts. Others do work for day programs. Many providers get trips from brokers. Since there are so many ways that business can be coming in to your company, your software needs to be flexible enough to handle all of those different types of trips, and offer features that help you effectively manage them.

The most common source of trips in NEMT is transportation brokers. Effective information sharing between NEMT providers and brokers is crucial to the success and growth of your business. Depending on your state, brokers may handle everything from assigning trips to providers, to submitting bills to the state. Proper integration with brokers not only saves you time, it allows you to operate much more efficiently, leaving room for growth.

Broker integration is frequently more complicated than people think, but there are comprehensive solutions out there. Some of the largest brokers in the nation award “approved software provider” status to systems that successfully and fully integrate with their systems. These software providers can pull assigned trips directly from the broker into the software, and may offer features like batch sign-off and integrated electronic billing generation and submission.

When you’re choosing an NEMT software, knowing how they integrate with the brokers you use, how they assist with routing, and how they make billing easier is crucial to helping you make the right choice for your business.

But there is so much more.

Features You Might Not Know To Ask For

Just because routing, billing and trip management are important doesn’t mean they’re the only features you should be asking about. NEMT software systems run the gamut, from highly intuitive, intelligent, adaptive systems to static processes that leave little room for personalized use. Depending on the size of your business, your future goals, and your current operational structure, you may benefit from a software that offers the highest-level solutions. Alternately, you may be in a place where you can settle for a software with fewer intuitive features that simply helps you reign in the physical paperwork requirements.

So what else is out there that you should consider before making your choice?

Import Validations

Let’s be honest: getting all the information into the system is important. But if that information is riddled with inaccuracies and errors, you are, at best, playing a zero-sum game of saving time.

Validating information as it’s being imported into your software is one of the most valuable features people don’t know to look for. Let’s examine what this looks like.

When it’s time to import trips and schedule out the day, you rely on that information being accurate and correct. Some of those trips will be new riders, addresses, and circumstances, and some of those trips will be repeat riders, addresses and circumstances. This information is what allows you to schedule drivers, collect trip information, assign the correct rates and codes, and submit completed forms for billing.

As you import the information for that day’s pre-planned trips, a highly intuitive software that validates information is checking to make sure it’s correct. It’s comparing rider information to existing profiles, ensuring you don’t end up with duplicates, and not relying on a single data point (like SSN) to do so. It’s verifying addresses, both with existing customer profiles and with map databases like Google and Microsoft, to ensure the address is both correct and real. It’s also validating trip schedules, ensuring that riders don’t have conflicting trips scheduled.

If you’re not sure why this kind of data validation is absolutely crucial to your operational efficiency, check out this blog that digs into this issue a little deeper. The long and short of it, however, is that by validating information, you eliminate many potential sources for waste. You won’t accidentally send drivers to the wrong address, or an address that doesn’t exist. You won’t have to merge profiles later on when you discover that a single customer has multiple profiles with different information. By ensuring all your information is correct, you ensure you’re not wasting time adjusting for errors.

Auto-Rates And Codes

Another feature many people don’t realize may be available is the ability for your software to automatically assign rates and codes to trips as they’re imported. Billing and Medicaid reimbursement require a complex system of rate and code assignation, and errors can result in denials and delays.

NEMT providers deal with complex rate structures, as well as strict reimbursement and billing requirements. Some software allows you to set up flexible rate structures based on specific criteria, which can then be automatically assigned to each trip as it’s imported. Same for those trips that require billing codes. These can be set up to be mileage-based, zone-based, round trip vs. one way, or any other factors that affect rates. Software systems designed with these features can save you an incredible amount of time, freeing up personnel to focus on other tasks.

Audit-Readiness and Report Generation

When you’re dealing with dozens to hundreds of trips each day, there is a lot of data involved. You may need to see trips that fit a certain set of criteria, such as trips per driver or trips with specific vehicle requirements. Not every software gives you the flexibility to control what information you’re seeing, or what information goes into reports.

At some point, you may be facing a compliance audit. When these roll around, they require years’ worth of specific information proving that you’ve delivered what you’ve billed for. If you don’t have this information, it can lead to months of headaches and red tape and, in some cases, having to repay reimbursed trips that weren’t properly documented.

When it comes to audit-readiness, you need a software with an internal audit trail that assists with monitoring compliance. Features like a driver app can offer critical safeguards for compliance and reporting requirements. These apps may offer features such as automatic timestamping and geocoding, offering verification that your drivers were where they said they were (this not only holds drivers accountable, but also protects them against no-shows). By investing in a software that assists with audit-readiness and allows you to generate custom reports, you can make sure your information is always accurate, up-to-date, and compliant.

Customer Experience

While this may not be at the top of your list when it comes to prioritizing software options, it may soon become more crucial than you think. With Uber and Lyft swooping in to offer NEMT transportation options, the customer experience game is changing. It’s no longer prudent to ignore customer experience when considering your business opportunities. Software that offers features like a client app, allowing them to view, edit and track all upcoming trips, not only enhance their experience but decrease no-shows, last-minute cancellations, and mix-ups.

The Non-Features You Need

Intuitive, easy-to-use features will get you and your business pretty far. But there’s always more to the story than great tools.

Room For Growth

Assuming you’d like your business to grow, you need a software with the flexibility to not just grow with you, but actively encourage growth. This means that your software makes the entire process more efficient so your staff has the capacity to get more done. It means that as you grow and add more customers, drivers, vehicles, and services, your software has the ability to handle the extra data.

Customer Service

When you’re switching to a new system, there is a learning curve. There is training, learning, and likely some mistakes along the way. You need to know not just how to use the system, but how to maximize it for your needs. A software company that makes the sale then leaves you high and dry is doing no favors to your business. Instead, you should look for a software provider that’s committed to providing the training and support you need to effectively use their product.

Conclusion

If you’re in the market for an NEMT software system, there’s a lot to consider. It’s important to do your research and compare a few different software systems to ensure you’re getting the right one for your needs. First, start with routing, billing and trip management abilities and features. Then examine the other features that may be included, such as data validation, automatic rates and codes, reporting tools, audit trails, and client experience features.

If you’re still not sure where to start, start right here with RoutingBox. We’re experts in the NEMT industry, and our highly intuitive software was built specifically for this market. We feature everything discussed above (except the “best route” button – we have a much better solution to that), in addition to hundreds of other benefits that allow your NEMT business to grow without limitations.