Communities without barriers
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Founded in 1995, MTM was born out of the need for centralized management of non-emergency medical transportation (NEMT) services. Helping the disabled, elderly, and other transportation disadvantaged populations with their transit needs is the core of our operations. An industry-leading NEMT manager, MTM leverages our extensive knowledge of the transportation and healthcare industries to deliver fresh approaches for increasing access to healthcare. Through our diverse product offerings, MTM helps clients meet challenges that are often left unfulfilled while collaborating to align incentives, reduce costs, and increase satisfaction. This approach directly supports our core mission of increasing the wellbeing of the populations we serve by removing community barriers, promoting independence, and improving health outcomes.
MTM Footprint Across the country, MTM’s clients gain process efficiency, cost containment, and improved customer service with our proven management methods. Since beginning our operations in Missouri in 1995, MTM has quickly expanded nationwide with current contracts in 28 states and the District of Columbia. With our vast presence, MTM has the ability implement new programs and provider networks seamlessly and efficiently.
Washington Montana Oregon
Maine
North Dakota Minnesota
Idaho
South Dakota
Vt. N.H. Wisconsin
New York
Michigan
Wyoming
Pennsylvania
Iowa
New Jersey
Nebraska Nevada
Illinois
Utah
Indiana
Ohio
Md. West Virginia
Colorado North
Del. Washington D.C.
Virginia
Kansas
California
Missouri
Pacific
Mass. Conn. R.I.
Kentucky
North Carolina
Ocean Tennessee
Oklahoma
Arizona
Arkansas
South Carolina
New Mexico Mississippi Alabama
Georgia
North Atlantic Ocean
Hawaii
Texas
Louisiana
Florida
Indicates states in which MTM operates
Headquarters and customer service center MTM customer service centers
Business office
In 2012, we scheduled more than seven million trips and service encounters for three and a half million members. Through our six customer service centers, we fielded approximately three million calls with the utmost attention to
Managed care organizations and health plans
high quality customer service. We currently have a varied client base, including contracts with:
State and county governments Transit agencies Area Agencies on Aging Health and human services departments
Advantage 24 7 365
Customer Service
Care Management
Network Management
MTM’s call centers continually exceed National Committee for Quality Assurance (NCQA) standards and provide multilingual services on a 24/7/365 basis. With specially trained agents dedicated to each service area, MTM leverages high quality resources to provide members with exceptional customer service while delivering value to clients.
As one of the first NEMT managers to deploy a care management approach, we provide person-centric care, enhanced coordination, and positive outcomes in each of our service areas. In particular, our Care Management department gives extra attention to members with high risk medical needs, providing extensive care coordination to ensure their health and wellbeing.
By building and maintaining networks of high-caliber service providers, MTM offers consistency and quality in all areas of network management—from recruiting, negotiating rates, contracting, and credentialing to reviewing claims and processing payments—to establish solid networks. Our methods ensure we meet the needs of clients in both urban and rural locations.
Quality
Your Members
Fraud & Abuse Reduction
MTM strives to provide the highest level of service by demanding quality from employees and network providers. We are URAC accredited and maintain satisfaction rates exceeding 95%. To keep this rate high, we are proactive in our improvement efforts by monitoring service, performing audits, conducting weekly satisfaction surveys, and addressing issues immediately.
Looking for opportunities to provide cost savings from every angle, our proven processes and automated systems methodically root out fraud, waste, and abuse. Our staff always verifies member eligibility, monitors service appropriateness, and conducts regular audits to ensure members receive necessary, appropriate services that are beneficial to their overall health.
Technology is the heart of MTM operations, enabling automation, protocol adherence, error reduction, and instant access to data. Our systems were custom built and include web-based portals, giving stakeholders on-demand access to data and service requests. Additionally, our call centers are linked, preventing downtime and allowing automatic call rerouting.
Services Transportation Management Care Coordination Ambulance Call Center Services Assessments & Travel Training
Transportation Management From sedan and ambulatory transports to higher levels of service such as wheelchair lift and stretcher van, MTM schedules more than seven million trips nationwide each year. Through our industry-best operating model that leverages comprehensive network management, innovative technology, extensive cost savings, and excellent customer service, we continually deliver efficiency and high quality service for a variety of diverse transportation programs. Thinking outside the box to provide customized solutions that cater to our clients’ unique needs, MTM takes on difficult transportation challenges and is a true one-stop transportation solution.
Non-Emergency Medical Transportation
Worker’s Compensation
MTM developed one of the first NEMT brokerage pro-
Getting injured workers back to work begins by
grams of its kind in Missouri in 1995, and has remained a
getting them to the medical services they need.
clear leader in NEMT management. We understand the
MTM has a robust network of national transporta-
complexities of serving Medicaid and Medicare popula-
tion providers that ensures injured workers receive
tions, including frail, elderly, and other transportation
timely, quality access to the care that will get them
disadvantaged passengers, and offer proven solutions
back on their feet.
for coordinating their needs efficiently.
Paratransit Services
Special Needs & Education
As demand for Americans with Disabilities Act (ADA)
For school districts facing decreased budgets and
paratransit services continues to grow while budgets
fluctuating enrollment, coordinating transporta-
tighten, innovative management is a must. MTM’s bro-
tion can be a costly, time-consuming process. By
kerage model centralizes scheduling, assigns passengers
outsourcing transportation to MTM, school systems
to lower modes of transportation, and maximizes un-
can stretch their valuable resources without sacrific-
dedicated, existing networks of vehicles to contain costs
ing the quality, safety, or reliability that is important
while increasing consistency and quality.
when transporting children.
Care Coordination MTM is redefining healthcare management through care coordination. As our clients strive to best serve their increasing aging and dual eligible populations, MTM offers care coordination activities to improve continuity of care, reduce fragmentation, and realize significant cost savings. Through our home and community based services, emergency room (ER) diversion, and discharge planning solutions, our clients and the populations they serve receive innovative, personalized approaches specific to their care coordination needs.
Home & Community Based Services MTM’s home and community based services program deploys network management and care coordination to deliver practical, personal solutions for keeping members happy and healthy in their homes. Care Coordinators personalize the care members need by managing credentialed networks of service providers such as personal care assistants, meal providers, home modification contractors, home health aides, and more. This model helps clients fill in their service gaps while our staff provides critical support to their case managers.
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. 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—not the hospital.
ER Diversion MTM can help reduce ER expenditures by identifying and educating patients who unnecessarily or frequently utilize ER services. Our diversion team contacts the patient, conducts a telephonic assessment, and connects them to the most appropriate, cost-effective resources for their condition. We communicate with the patient regularly, encouraging primary care visits and relationships. Follow-up ensures that individuals keep their scheduled appointments and re-education is performed as necessary.
Ambulance Studies show that each year, approximately 25% of ambulance transports are inappropriately utilized or billed—resulting in nearly $500 million in avoidable costs. As more health plans face the increasing challenge to reduce inappropriate expenditures, MTM delivers a centralized solution for non-emergent and emergency ambulance services. Built upon our extensive experience in the transportation industry, this wellrounded approach provides up to a 25% reduction in ambulance claims expenses while increasing compliance and reducing fraud.
Ambulance Provider Network Management By establishing comprehensive networks of credentialed ambulance providers, MTM increases program quality and passenger satisfaction. Providers must meet our stringent requirements and are contracted at a standardized, fair price. We provide ongoing education to ensure understanding with our expectations, and facilitate regular monitoring for compliance.
Prior Authorization & Medical Necessity Determination Under our model, all non-emergent ambulance claims must be prior authorized. As part of this process, we conduct level of need assessments to verify a passenger’s need for ambulance services. Following authorization, we schedule transport with our network of credentialed providers, supported by our 24/7/365 call center operations.
Claims Processing, Adjudication & Payment Clients also benefit from our centralized model for processing, adjudicating, and paying ambulance claims. We thoroughly review all submitted claims and supporting documentation, including pick-up and drop-off times and passenger signatures, to ensure service was actually rendered and eradicate inaccurate, fraudulent claims.
Appeals Management MTM also has processes in place to manage provider claims appeals in an appropriate, fair manner and ensure the issue is resolved quickly. We maintain thorough, accurate records of all claims documentation, ensuring our staff can impartially assess the denial while protecting against fraud. If the appeal is validated, we immediately issue payment to the provider.
Call Center Services MTM has managed customer service and member outreach within our call center operations since our inception. Outside of scheduling and reservation
Introduce newly eligible members to their health plan
functions, our call center solutions assist health plans in reaching out to their members. Our experienced and trained representatives provide both inbound and outbound calling to:
Inform members of benefit information Provide education to reduce ER utilization Re-enroll members close to benefit expiration
Technology & Efficiency
Experience & Reliability
With call centers strategically placed throughout the country, our locations are linked by an advanced phone system that prevents down time and allows calls to be seamlessly routed between locations based on capacity and call volume. The system has the capability to transform calls into rich, multimedia experiences customized to meet specific needs and criteria. Available features include automatically segmenting and routing calls, Interactive Voice Response (IVR) technology, and meaningful reporting.
Throughout our existing customer service centers, MTM’s expert staff handles more than three million calls each year while maintaining industry-leading satisfaction rates and exceeding client and NCQA standards. Our representatives are experienced in working with members of various health plans, and are specially trained to adhere to client-specific protocols. MTM answers calls 24 hours a day, seven days a week, 365 days a year without interruption.
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.
That is a covered service. Will my appointment be covered?
How can I get a new ID card?
Assessments & Travel Training MTM’s healthcare and transportation knowledge helps us understand the goals of the ADA paratransit eligibility process, as well as the complex issues that affect individuals with disabilities and older adults. From this understanding, we developed our On the Move program for assessment and travel training activities for transit agencies, communities, school districts, and other entities serving special needs populations. Through On the Move, we help clients increase the independence of the populations they serve and facilitate better access to the community.
Assessments
Travel Training
Instead of considering a medical diagnosis as a firm eligibil-
For individuals who are capable of utilizing fixed
ity determination, our assessments focus on actual function-
route bus or rail systems but may require assis-
al and cognitive abilities. Our qualified, trained evaluators
tance before doing so, On the Move travel train-
utilize recognized tools such as the Functional Assessment
ers provide comprehensive instruction in real-life
of Cognitive Transit Skills (FACTS) test to determine barriers
transit scenarios to familiarize the individual with
that may impact an individual’s ability to safely and inde-
local transportation options. Varying travel train-
pendently access public transit. On the Move offers several
ing services—including one-on-one, classroom/
types of assessments, including:
group, and train the trainer—are customized to help individuals gain new skills, overcome fears,
ADA assessments
and build confidence.
Special needs assessments For the individual trained, increased confidence,
General mobility assessments
self-reliance, and community integration are immediate results of learning to travel indepen-
In all cases, assessments utilize the standards and meth-
dently. Travel training also benefits the clients
odologies of national organizations such as the National Transit Institute (NTI) and Easter Seals Project ACTION (ESPA).
and communities we work with by reducing program expenses and paratransit utilization
Evaluations follow a comprehensive process to accurately
while increasing the use of cost-effective public
determine if an individual can safely access public transit
transit systems.
either with or without travel training.
Assessment process 9 9 9
1.
2.
3.
4.
5.
Application
In-Person Interview and/or Assessment
Recommendation
Travel Training
Transportation Scheduled