How Technology Is Changing The Face Of NEMT Industry?

Millions of people all around the world, who somehow miss medical care due to lack of transportation services, they can experience a significant improvement in terms of medical transportation with the help of NEMT (Non-Emergency Medical Transportation) services. Digitally integrated NEMT services reduce barriers to healthcare transportation.

Non-Emergency Medical Transportation services
The Current NEMT Industry: With Traditional Technology
As being one of the vital components of the healthcare system in the USA, annually US$5 million is spent by Medicaid and other health plans to provide the NEMT benefits which include the transportation of patients to and from doctor's appointments, dialysis centers, and other healthcare visits. Every year, the NEMT network covers nearly 104 million trips. The demand for the service is increasing with the rise in the elderly population and life expectancy rate. The surge in the total revenue of global healthcare transportation certainly indicates the expansion of the industry.

With the rising demands, to provide the top-notch service, healthcare centers, and insurers need to utilize new technology to manage the operations smoothly, maintaining transparency. The new aspects like ridesharing, autonomous vehicles, and more are being introduced to be used in the NEMT business for optimization and better customer experiences.

Result Of Lack Of Up-to-date Technology: Malpractice In The NEMT Industry
Challenges In NEMT Industry

Being a lifesaving aspect of the Medicaid program, the volume and magnitude of the industry are enormous. So, inefficiencies and malpractice results in billions of lost revenue misused funds along with higher healthcare costs.

Factors Causing Misuse of Funds:
Fraud:

Use of traditional and conventional ways like phone and fax to track and monitor trips leaves the scope for fraud. Lack of updated technology like GPS provides the chances to produce increased mileage on trips, unavailability to book an appropriate vehicle prevents fudge medical necessity to invoice more expensive vehicle trips, Billing for the trips which never took place increases the nations health-care cost.

Some Instances of Fraud Practices:

The dialysis patients who didn't need ambulance transportation were provided the service. Hence, to settle the claims, two ambulance programs in Connecticut paid almost US$600,000.
As reported by the Centers for Medicaid and Medicare Services (CMS), the practice of attributing the rides to ceased people landed Massachusetts NEMT provider in jail with a fine of approximately US$475,000.
The mother faced imprisonment of 30 days with a fine of worth US$21,500 for the trips which never took place. She had billed for child treatment trips to Medicaid.
Missed Medical Appointments :

Lack of streamlined systems in the industry results in an increased number of missed medical appointments. Annually 3.6 million patients miss their medical appointments. It causes more hospital stays and extra expenditure on healthcare.

Unnecessary Service :

A practice known as "upcoding" means charging for unnecessary medical devices and support (such as an Advanced Life Support -ALS when only Basic Life Support-BLS is needed.) Companies earn their profit through this practice. A dialysis patient is provided an ambulance when a wheelchair car will do. But it costs him double.

High Administrative Cost:

The most time-consuming tasks in the NEMT industry are scheduling and billing. Healthcare service providers or NEMT transportation service providers arrange a trip for patients only after checking the eligibility. If the client is eligible, scheduling and billing require more staff to get the task done unless up-to-date tools and technology are used.

In a discussion on high administrative cost with National Public Radio Harvard economist David Cutler presented an example of Duke University Hospital, which has 1300 billing clerks and 900 beds. This additional staff is needed to make accurate bills that meet the requirements of various insurance providing companies.

Extra Cost For The Same Service:

When a regular vendor is unavailable, you may have to rely on another provider. It may cost more to the provider, and the customer as the charges for the service may vary.

Measures To Attain Profitable Business With The Provision Of Cost-effective Services:
In this modern age where technology is making radical changes in every field, the NEMT sector is no exception. Using well-equipped tools to maintain the NEMT operation can bring about the desired changes.

Discarding old and traditional methodology of using phone and fax, utilization of technologically advanced tools, applications, and software to execute all the commands and operational tasks required for successful completion of NEMT trips with bringing the operation on an online platform can be used. This technology facilitates us with monitoring and managing the operations along with providing the exact data like web-enabled time stamps of actual pick-up and drop time, making billing and scheduling so easy, getting online, and instant feedback from clients for evaluating the performance of service providers for better results.
Evaluation of the performance of the service provider can bring about a healthy competition, which results in the elimination of the companies that are are not performing well in the industry. The allotment of trips on the basis of quality and care can be managed to keep client satisfaction at the topmost priority.