A Driving Force in Non-Emergency
Medicaid Transportation Management
Medicaid Transportation Management
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| Type | Action | Invoice PA# SO Exp Date |
Status Caller Info Disposition |
Trip Date Mode Last Updated |
Enrollee Driver/Vehicle |
Trip Legs |
|---|
| Trip Date | Invoice # | Enrollee | Reason | Trip Status | Correction Status | Actions |
|---|
| Reason | Refused By | Refuse Date/Time | Trip Date | Enrollee |
|---|
| View | Created | Status | Source | Concern Type | Outcome |
|---|---|---|---|---|---|
| 07/01/2020 | Provider Review | Enrollee | No Show | Pending | |
| 07/01/2020 | Closed | Enrollee | Cost Concern | Notified | |
| 07/01/2020 | Closed | MP | Fraud | Notified |
| Action | Invoice PA# |
Trip Date Disposition |
Enrollee First Name Enrollee Last Name |
Trip Legs |
|---|
Please select a reason to undo attestation for this trip.
If unable to accommodate this trip, please proceed with refusal reason and trip will be reassigned.
If this trip was canceled by a Medical Provider or Enrollee, please return to trip roster and select "Trip Cancel".
Are you sure you want
to refuse this trip?
It cannot be undone.
| Enter Your Requested Correction Below: (Limit 1000 characters) |
| Mileage calculations are based upon NYSDOH guidance. Transportation Providers are to use the shortest, most appropriate route according to Google. |
PA Number Correction.
Pressing Submit will send the Request as a notification.
Note: It may take up to 24 hours for the PA Number to generate after attestation.
GPS breadcrumb milestone data is incomplete for this trip invoice.
| Change the address on invoice | |
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| Action (Status) | Last Name | First Name | Drivers Lic # (State) | Expiration | Mobile Login | Set driver |
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Note: Reassigns can only be made if a trip has not been attested. If a trip is reassigned after it has been started, the newly assigned driver will be displayed once he or she resumes the trip in the mobile app.
| Status |
Active
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| Mobile Login |
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| Last Name | |
| First Name | |
| Direct Phone | |
| Email Address | |
| Driver License # | |
| Driver License State | |
| Expiration |
Must enter a valid date
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| Last Name | First Name | Expiration |
|---|---|---|
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Must enter a valid date
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| Vehicle Type | Vehicle Name | Reg Expiration |
|---|---|---|
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Must enter a valid date
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| Status | Vehicle Type | Vehicle Name | License Plate # | Reg Expiration |
|---|---|---|---|---|
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Must enter a valid date
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If this trip is still needed, but you're unable to accommodate it, use Trip Roster to refuse the trip and it will be reassigned.
If this trip was canceled by a Medical Provider or Enrollee, please proceed by selecting the appropriate option.
Are you sure you want to attest to the entire trip as "Canceled"?
Please review this recent information that may be important to you.
| From | Date | Subject |
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Please select the profile to use.
| Company Name | County | Action |
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