Communities without barriers
Founded in 1995 by Peg and Lynn Griswold, MTM was born out of a need for centralized management of non-emergent medical transportation. After realizing the difficulty health plans and government organizations had in arranging transportation services, founders Peg and Lynn Griswold were determined to develop a company that would ensure more people had access to health care. Their company, Medical Transportation Management (MTM), quickly set industry standards and is now one of the largest and most established managers of non-emergent transportation services.
MTM Advantage MTM’s Approach to Quality Healthcare & Transportation Management Since its inception, MTM has remained committed to its mission of removing barriers for individuals attempting to access healthcare and community services. Across service lines, MTM works to achieve its mission while delivering responsible, cost-effective results to its clients. MTM’s approach to healthcare and transportation management is a constantly evolving model that allows us to provide customized solutions that cater to each program’s unique needs. Our priorities are to:
Deliver value to our clients.
Develop the best networks
As budgets tighten, and demand for services continues to rise, MTM is committed to helping clients do more with less. MTM looks for opportunities to provide cost savings to our clients at every turn, starting by negotiating fair rates with network providers. Our proven processes and automated systems methodically root out fraud, waste, and abuse and ensure that only eligible members receive services.
By building and maintaining networks of high-caliber providers, MTM offers consistency and high-quality service to its clients. We recruit, screen, negotiate, contract, credential, and train providers to establish rock-solid networks that ensure MTM is able to meet the needs of individuals anywhere in the U.S., from urban areas to the most remote rural locations. Our network providers enjoy the convenience of online credentialing and claims management, which allows them to quickly and easily submit information and receive prompt payment.
Manage with care MTM was the first in its industry to utilize a care management approach that provides a person-centric focus and enhanced coordination of services. Our goal is to implement responsible solutions and reduce wasteful spending by addressing the overall health of the individual to determine what services will make the most significant impact. MTM’s Care Management Department provides extra attention to those situations that require more intense review, special care beyond a standard request, or interaction with health care professionals.
Utilize the right technology
Demand Quality
Technology is at the heart of MTM operations, enabling us to automate processes, ensure adherence to protocols, reduce user error, and instantly access information. Our custom-built systems were developed specifically for our purposes by our team of experts, which allows us to make adjustments as needed. This system includes a series of web-based portals which allow providers, clients, and members on-demand access to information, reports, and service requests. In our call centers, which are linked together to prevent down-time.
MTM strives to provide the highest level of service in our industry by demanding quality from its employees and network providers. Working diligently to recruit and retain reliable employees, MTM provides an intensive training process and offers career paths and bonus programs to motivate and encourage retention. These committed team members help us achieve industry-leading customer satisfaction rates that exceed 95%. Regular audits, recorded calls, and surveys help us keep our fingers on the pulse of our business and ensure that we are proactive in our continuous improvement efforts.
Services Transportation Management Your One Stop Transportation Solution
Care Coordination Transforming Healthcare
Ambulance Full Service Claims and Adjudications
Call Center Services A Friendly Voice for Your Customers
Assessment & Travel Training Improving Independence Through Public Transit
Transportation Management
MTM manages non-emergency medical transportation (NEMT), thinking outsidethe box to provide customized solutions that cater our services to our clients’ unique needs. With over 16 years of experience in the industry, MTM can help you take on your biggest challenges. From bringing additional funding to your program through grant writing and research, to implementing in-person assessments and travel training that encourage low-cost mode assignment, to routing and scheduling; our goal is to be your one-stop transportation solution.MTM is one of the nation’s largest and most experienced transportation management firms, yet it remains family-owned and operated.
Workers’ Compensation From sedan transport, to wheelchair van service, to air ambulance, MTM delivers efficiency, cost savings, and high quality service to handle your most basic or challenging workers’ compensation transportation needs; 24 hours a day, 7 days a week, 365 days a year. Getting injured workers back to work begins by getting them to the medical services they need. MTM has a robust network of regional and national transportation providers that will ensure that each injured worker has timely and quality access to the care that will get them back on their feet.
Paratransit Services
Special Needs & Education
MTM can operate all phases of your paratransit program under one contract, from implementation and management, to turnkey services. Understanding the unique needs of each community, city, and organization, MTM offers individualized solutions and options to help you reduce cost, increase customer satisfaction, and improve efficiencies.
As school systems and districts face decreased budgets and fluctuating enrollments, coordinating education based transportation can be a costly and time-consuming process. By outsourcing transportation to MTM, organizations are able to stretch their valuable resources, saving an average of 10-30% overall, without sacrificing quality, safety, or reliability.
MTM offers its paratransit clients eligibility screening, functional and cognitive assessments, travel training, call center operation, and certified drivers and vehicles.
MTM provides transportation for public and private schools, day treatment plans, partial hospitalization programs, and other special needs programs.
Care Coordination
Driving a paradigm shift in healthcare, MTM is redefining personalized home and community based services management and transforming delivery of quality care in the home to the increasing aging and dual-eligible populations. MTM’s goal is to help clients improve continuity of care, reduce fragmentation, provide enhanced person-centered care, and realize significant cost savings. MTM uses a model that delivers support for people with complex needs by utilizing specialized care planning, comprehensive coordination, early detection, improved access, and personalized tele-health services.
Home & Community-Based Services MTM is redefining home-based, personalized care management by assembling all critical functions of home healthcare and integrating them into one unified, person-centric home healthcare solution. Our care managers begin with an in-person assessment and then coordinate care through a credentialed network of home healthcare professionals. Our home care coordination team ensures continuity of care, improved health outcomes, and increased member satisfaction.
Discharge Planning As healthcare evolves, hospitals and health plans alike are migrating to outpatient care-focused models to achieve quality improvement goals and curb avoidable readmission penalties established by the Patient Protection and Affordable Care Act. According to a New England Journal of Medicine study, 34% of Medicare patients were readmitted to a hospital within 90 days of discharge and 56% were readmitted within one year. Appropriate discharge planning is the key element to ensuring members receive follow-up care from their primary care physician窶馬ot the hospital.
ER Diversion MTM can help you reduce Emergency Department (ED) expenditures by helping you identify and educate members who unnecessarily or frequently utilize those services. Our diversion team will contact the individual, conduct a telephonic assessment, and then connect the patient to the most appropriate, cost-effective services and resources for their condition. We communicate with the individual regularly, encouraging primary care visits and PCP relationships. Follow-up is also provided to ensure that individuals keep their scheduled appointments and re-education is performed when necessary.
Ambulance MTM provides a complete non-emergent and emergent ambulance claims management and adjudication solution for health plans. We offer the following services, combined or individually, to our clients: 路 路 路 路
Ambulance Network Management Prior-Authorization & Medical Necessity Determination Appeals Management Claims Processing, Adjudication, and Payment
Claims Processing, Adjudication, and Payment With our claims management solutions, our clients benefit from a centralized model for processing, adjudicating, and paying claims for service submitted by ambulance providers. As part of our standard processes, we review all submitted claims and supporting documentation, including pick-up and drop-off times and passenger signatures, to ensure the service was actually rendered. Our review staff also confirms passenger eligibility for the day of service, and provides final approval for timely payment to the provider.
Appeals Management In some cases, ambulance providers may not agree with our decision to deny payment based on lack of supporting documentation or suspected fraud. If delegated, MTM has processes in place to manage provider appeals. Our approach offers an appropriate, fair review by an unbiased staff member to ensure the issue is resolved quickly. We maintain thorough, accurate records of all claims documentation, ensuring our appeals review staff can assess the denial in an unbiased manner while still protecting against fraud. If the appeal is validated, we immediately issue payment to the provider.
Prior Authorization Across the country, our clients face the increasing challenge to accurately centralize ambulance authorizations and claims management functions. Under our model, we require all non-emergent ambulance claims to be prior authorized. As part of this process, we conduct level of need assessments with passengers to verify the need for ambulance services. Following need determination and authorization, we schedule transport with our network of credentialed providers. All scheduling and authorizing functions are supported by our 24/7/365 call center operations.
Ambulance Provider Network Management By establishing comprehensive networks of credentialed and contracted ambulance providers throughout our service areas, MTM is able to increase program quality and passenger satisfaction. Each provider must meet MTM’s stringent requirements and is contracted to provide trips at a standardized, fair price. Within these networks, we provide ongoing education and outreach to ensure understanding with our expectations, and facilitate regular monitoring and management for continual compliance.
Call Center Services MTM’s call center services were developed to assist health plans in reaching out to their members. MTM can provide both inbound and outbound calls to: · · · ·
Introduce newly eligible members to their health plan Inform members of benefit information Provide education to reduce emergency department usage Re-investigate and re-enroll for members who are close to benefit expiration.
Open the lines of communication. MEMBER Welcome to the plan. What is my deductible?
Do you have a primary care provider?
It is time to re-enroll.
Experience & Reliability MTM’s customer service centers currently handle more than three million calls each year while maintaining industry-leading satisfaction rates and exceeding NCQA standards. Our customer service representatives are experienced in working with the managed care organization members and are specially trained to adhere to health plan protocols. MTM answers calls 24 hours a day, seven days a week, 365 days a year without interruption.
That is a covered service. Will my appointment be covered?
How can I get a new ID card?
Technology & Efficiency MTM’s multiple call centers are linked by a phone system that prevents down-time and allows calls to be routed based on capacity and call volume. The system has the capability to transform customer service calls into rich multimedia experiences that can be customized to meet very specific needs and criteria. Available features include automatically segmenting and routing customers, utilizing interactive-voiceresponse (IVR) technology, and rich reporting.
Assessment and Travel Training
MTM’s assessment and travel training program, On the Move, was created to assist communities, school districts, and other special needs populations. MTM performs an assessment to evaluate the individuals’ transportation needs, eligibility, and, where appropriate, provides travel training as a result. MTM’s On the Move program provides full management of assessment and travel training processes, leaving you to focus on other aspects of your operation. Transit organizations,school districts, Medicare health plans, Intellectual and Developmental Disabilities (IDD) Programs, and more can all benefit from our services.
Assessment
Travel Training
MTM’s Assessment program is offered as a standalone solution for communities, school districts, and other special needs population, as well as in combination with MTM’s NEMT management services.
MTM provides travel training to individuals who are capable of using the public transit system, but require some assistance to get started. Travel training is arranged in the member’s community, using real buses and situations and is designed to familiarize the member with local transportation options.
Assessments are performed by qualified staff trained using the standards and methodologies of national organizations such as the National Transit Institute and Easter Seals Project ACTION (ESPA). In addition, they use industry-standard tools such as the Functional Assessment of Cognitive Transit Skills (FACTS) .
Travel training can be offered as an independent service, but in most cases, travel training follows ADA, general mobility, or special needs assessments. Assessing individuals in advance of travel training ensures that recommended candidates have the potential to benefit from the training.
9 9 9
1.
2.
3.
4.
5.
Application
In-Person Interview and/or Assessment
Recommendation
Travel Training
Transportation Scheduled