Transportation I H C P A n n u a l. S e m i n a r

Transcription

1 Transportation I H C P A n n u a l S e m i n a r

2 VERMILLION CareSource Transportation Vendors CareSource partners with two vendors for transportation: Ride Right (northern Indiana) LCP (southern Indiana) Marion county is divided between the two partners based upon zip code of member. ST. JOSEPH ELKHART LAGRANGE STEUBEN LAPORTE LAKE PORTER NOBLE DEKALB MARSALL STARKE KOSCIUSKO WHITLEY ALLEN JASPER PULASKI FULTON NEWTON WABASH WHITE CASS MIAMI WELLS ADAMS BENTON CARROLL HOWARD GRANT WARREN TIPPECANOE JAY CLINTON TIPTON DELAWARE FOUNTAIN MADISON RANDOLPH MONTGOMERY BOONE HAMILTON HENRY WAYNE HANCOCK PARKE HENDRICKS MARION PUTNAM RUSH FAYETTE UNION SHELBY MORGAN JOHNSON VIGO CLAY FRANKLIN OWEN DECATUR MONROE BROWN SULLIVAN RIPLEY GREENE JENNINGS OHIO JACKSON LAWRENCE SWITZERLAND JEFFERSON KNOX DAVIESS MARTIN SCOTT WASHINGTON ORANGE CLARK PIKE DUBOIS GIBSON CRAWFORD FLOYD Ride Right LCP POSEY WARRICK SPENCER PERRY HARRISON 2

3 Contact Numbers for Transportation LCP Ride Right Reservations LCP Hearing Impaired (TTY) Direct Dial LCP Reservations Direct Dial Ride Assistance or or

4 Hours and Days of Customer Service Operation Routine Reservations Ride Assistance (Where s My Ride) & Hospital Discharges Urgent & Discharges Monday through Friday, 8 a.m. to 8 p.m. (EST) Routine reservations are not accepted Saturday or Sunday. 24/7/365 Calls for urgent and discharges are accepted on national holidays (New Year s Day, Memorial Day, 4 th of July, Labor Day, Thanksgiving and Christmas), despite CareSource Customer Service being closed. 4

5 Requesting & Receiving Transportation Who can request transportation? Members must be at least 18 years of age, unless they are pregnant or an emancipated minor. The member s CareSource case manager or other plan representative Providers What information is needed to request transportation? Members should have their member ID and all available information about the date/time of their appointment Who can receive transportation? Member must be at least 18 years of age to travel alone, unless they are pregnant, an emancipated minor or have a signed waiver form on file indicating a parent has approved their transportation. If the member is a single caregiver with more than one minor child in his/her care, CareSource authorizes our vendors to transport the additional minor children. CareSource authorizes transport of both parents/guardians. 5

6 Advance Notice Routine and Urgent Medical Appointments Routine trips must be requested at least 48 hours (2 business days) in advance. Trips are accepted no more than 45 days prior to an appointment. Members receive a confirmation number. 6

7 Pick Up Timeframes Picks ups prior to appointments For local trips, our vendors have two (2) hours to pick members up for: Urgent hospital discharges ER discharges Urgent care discharges Same day urgent provider appointments for local trips less than or equal to fifty (50) miles For rural trips, our vendors have four (4) hours to pick members up for: Urgent hospital discharges ER discharges Urgent care discharges Same day urgent provider appointments for local trips less than or equal to fifty (50) miles Return trips Our vendors have two (2) hours to pick up members for local and rural trips 7

8 Trip Limitations for Hoosier Healthwise 20 one-way trips of less than 50 miles per rolling year without prior authorization Trips greater than 30 miles one-way require verification of the appointment with the facility. Prior authorization is required for any trip over 50 miles in distance or trips beyond 20 one-way in a rolling year except: Hospital-related trips Paralift trips Nursing home trips Methadone treatment Dialysis 8

9 Trip Limitations (continued) Not covered: Meals and/or lodging Emergency visits Pharmacy trips, unless following an approved trip WIC and redetermination trips are allowed 9

10 Modes of Transportation Mass transit, i.e. bus pass Ambulance, i.e. sedan, van, taxi Wheelchair lift-equipped vehicle Bariatric capable vehicles and/or stretcher 10

11 Mass Transit CareSource covers public transportation if mass transit is both available and appropriate. Public transportation is available to and from appointment The distance between the member s residence and the medical appointment is no more than half a mile from the member s pick up and drop off location Member is ambulatory 11

12 Car Seats Required by law for children ages 0 to four years of age Member is required to bring all necessary wheelchairs, child safety seats and any other durable medical equipment (DME) to/from the appointment LCP provides booster seats for children four to eight years of age and weighing 40 to 80 pounds. Ride Right does not provide booster seats 12

13 Contact Information Contracting Concerns Bruce Bowlin LCP Claudette Pickens Ride Right Ryan Taylor Provider Management Representative 13

14 Thank You! 14 IN-P-0280 Date Issued: 10/17/17 Date Approved: 9/20/17