1. Indiana County Department Of Human Services Medical Assistance Transportation Program

2. MATP Requirements The client must have medical assistance (Medicaid) through Indiana county. The client must have medical assistance (Medicaid) through Indiana county. The client must live in Indiana county. The client must live in Indiana county.

3. MATP Requirements We verify the clients eligibility through the Department of Public Welfare Promise website. We verify the clients eligibility through the Department of Public Welfare Promise website. Clients can complete an eligibility form over the phone. Clients can complete an eligibility form over the phone. Clients can also come into the MATP office and complete an eligibility form. Clients can also come into the MATP office and complete an eligibility form. The MATP office must use the most cost effective mode of transportation and will complete a needs assessment with the caller. The MATP office must use the most cost effective mode of transportation and will complete a needs assessment with the caller.

4. MATP Requirements Once the client is determined eligible the client can use the program. Once the client is determined eligible the client can use the program. The client must sign and date an eligibility form and return it to the MATP office within the 30 day period. The client must sign and date an eligibility form and return it to the MATP office within the 30 day period. If an eligibility form is not received at the end of this period the client will become ineligible and cannot use the program. If an eligibility form is not received at the end of this period the client will become ineligible and cannot use the program.

5. Services Offered Bus tickets Bus tickets Mileage reimbursement Mileage reimbursement Direct transportation Direct transportation

6. Bus Tickets

7. If the client lives on a bus route they must use bus tickets for local appointments. If the client lives on a bus route they must use bus tickets for local appointments. The clients can call four days in advance and a bus ticket will be mailed to them. The clients can call four days in advance and a bus ticket will be mailed to them. The clients can pick up bus tickets at the MATP office. The clients can pick up bus tickets at the MATP office.

8. Bus Tickets Bus tickets must be signed by a medical provider. Bus tickets must be signed by a medical provider. If the ticket is not used the client is required to send the ticket back to the MATP office. If the ticket is not used the client is required to send the ticket back to the MATP office. The bus tickets are only good for the date of the appointment written on the ticket. The bus tickets are only good for the date of the appointment written on the ticket.

9. Bus Tickets The client will be sent out reminders, if during a calendar month they: The client will be sent out reminders, if during a calendar month they: Do not have a ticket signed by a medical provider. Do not have a ticket signed by a medical provider. Do not return the documentation stub to the MATP office when not riding home on the bus. Do not return the documentation stub to the MATP office when not riding home on the bus. Change the date or destination without permission from the MATP office. Change the date or destination without permission from the MATP office.

10. Bus Tickets If the medical provider changes an appointment the client can contact the MATP office, we will document the change and permit the client to change the ticket. If the medical provider changes an appointment the client can contact the MATP office, we will document the change and permit the client to change the ticket. The client can call in 3 times in one month to change bus ticket information. The client can call in 3 times in one month to change bus ticket information. The client must provide the MATP office with the date, doctor/facility name, and bus ticket number in order to change over the phone. The client must provide the MATP office with the date, doctor/facility name, and bus ticket number in order to change over the phone.

11. Mileage Reimbursement

12. Examples of appointments that may be covered under mileage reimbursement: Examples of appointments that may be covered under mileage reimbursement: Chiropractor Dental Office Dialysis Clinic Doctors Office Drug & Alcohol Facility Hospital Medical Supply Mental Health Facility Mental Health Summer Camp Methadone Clinic Pharmacy Physical Therapy

13. Mileage Reimbursement We offer 25 cents a mile. We offer 25 cents a mile. The mileage reimbursement forms must have original signatures from both the client and the medical provider. The mileage reimbursement forms must have original signatures from both the client and the medical provider. The MATP office uses two different types of mileage forms, one per visit for different providers and one for multiple visits to the same provider. The MATP office uses two different types of mileage forms, one per visit for different providers and one for multiple visits to the same provider.

14. Mileage Reimbursement The MATP office uses an internet mapping software to verify all mileage, such as, Superpages, Mapquest, and Yahoo Maps. The MATP office uses an internet mapping software to verify all mileage, such as, Superpages, Mapquest, and Yahoo Maps. We do not reimburse for side trips such as, shopping, detours, etc. We do not reimburse for side trips such as, shopping, detours, etc. If the clients travel to two or more doctors in one day then the total round trip mileage will be split between the two providers. If the clients travel to two or more doctors in one day then the total round trip mileage will be split between the two providers.

15. Mileage Reimbursement Mileage reimbursement forms are due on a bi-weekly schedule. Mileage reimbursement forms are due on a bi-weekly schedule. Mileage reimbursement checks are mailed out the following week. Mileage reimbursement checks are mailed out the following week. For example, if today is August 7, the forms would be due August 15 and the checks would be mailed on August 22. For example, if today is August 7, the forms would be due August 15 and the checks would be mailed on August 22.

16. Direct Transportation

17. Transportation provided to the following counties: Transportation provided to the following counties: Allegheny Allegheny Armstrong Armstrong Cambria Cambria Clearfield Clearfield Jefferson Jefferson Indiana Indiana Westmoreland Westmoreland

18. Direct Transportation: Scheduling a Ride How does the client schedule a ride? How does the client schedule a ride? Get the name/address/phone number and Medical Assistance Provider Number of the doctor or facility. Get the name/address/phone number and Medical Assistance Provider Number of the doctor or facility. The date and appointment time. The date and appointment time. Call 2 days in advance and before 2:00 p.m. Call 2 days in advance and before 2:00 p.m. Call the MATP scheduler at 724- 471-7300 or 1- 866-646-6287. Inform the scheduler if the client has any special needs, such as a wheelchair or if an escort needs to go with them.

19. Direct Transportation: Pick Up and Drop Off Guidelines The client will be told in advance the approximate time and location they will be picked up by the MATP transportation provider. The client will be told in advance the approximate time and location they will be picked up by the MATP transportation provider. The client should be ready ahead of time. The client should be ready ahead of time. The transportation provider will pick the client up no sooner than 15 minutes before their scheduled time.

20. Direct Transportation: Pick Up and Drop Off Guidelines If the driver is later than 15 minutes after their scheduled pick up time, contact the MATP scheduler. If the driver is later than 15 minutes after their scheduled pick up time, contact the MATP scheduler. The transportation provider will drop the client off no more than one hour before their scheduled time. The transportation provider will drop the client off no more than one hour before their scheduled time. The transportation provider will pick the client up no later than one hour after their scheduled appointment has ended. The transportation provider will pick the client up no later than one hour after their scheduled appointment has ended.

21. Direct Transportation: Canceling a Ride Call the MATP scheduler 24 hours (1 business day) in advance before 2:00 p.m. Call the MATP scheduler 24 hours (1 business day) in advance before 2:00 p.m. If the client calls after 2:00 p.m. or if they call the day of the appointment this will be considered a late cancellation. If the client calls after 2:00 p.m. or if they call the day of the appointment this will be considered a late cancellation. If the client does not go to their appointment, this will be considered a no show.

22. Direct Transportation: Canceling a Ride The client will receive a late cancel or no show notification letter and they can appeal. The client will receive a late cancel or no show notification letter and they can appeal. If the client receives 3 no shows and or late cancellations in a month they will be sanctioned from the program. If the client receives 3 no shows and or late cancellations in a month they will be sanctioned from the program. The client can appeal a no show, a late cancellation, and sanction notice. The MATP staff will review the appeal.

23. Direct Transportation: Escort Policies We require that an escort form be completed in order to have someone accompany a client to a medical appointment. We require that an escort form be completed in order to have someone accompany a client to a medical appointment. The client must complete the front side of the escort form, then have a medical provider complete the backside. The client must complete the front side of the escort form, then have a medical provider complete the backside. Once the form is completed and received by the MATP office the client can have an escort accompany them to any future appointments. Once the form is completed and received by the MATP office the client can have an escort accompany them to any future appointments.

24. Direct Transportation: Escort Policies The escort form must have original signatures from both the client and the medical provider. The escort form must have original signatures from both the client and the medical provider. If the client needs an escort and there is a time constraint, we will also accept a faxed script from the doctor. If the client needs an escort and there is a time constraint, we will also accept a faxed script from the doctor. This will only provide an escort for the day of service the escort is needed. This will only provide an escort for the day of service the escort is needed.

25. All of This Information Can Be Located at the Indiana County Department of Human Services Website. http://humanservices- countyofindiana.org