The task of assuring appropriate, safe, professional, and timely transportation for a network of clients is one requiring aggressive and detailed planning. Organization and clearly defined procedures have been developed and implemented. LCP provides one central location to serve as a statewide call center. This simplifies the process for the members. This central call center can verify member eligibility and determine the most efficient, yet cost effective, means of providing transportation.
The following is a list of some of the seamless solutions we offer:
Transportation utilization information received from the transportation provider networks will be accessible to Medicaid Managed Care Programs through relational databases and maintained for the length of the contract requirements. We provide Medicaid Managed Care Programs with flexible, sophisticated reporting as well as systemic audit trails. This tracking mechanism allows Medicaid Managed Care Programs the necessary reporting required to track all inquiries in the system. LCP monitors transportation vendors and confirms compliance with all pertinent standards through periodic vehicle and on-site inspections. LCP currently utilizes numerous vendors throughout the state of Indiana to help provide non-emergency and urgent transportation.
LCP uses its current transportation system to integrate existing information management systems and desired enhancements to a relational database scalable to the MCO/HMO’s network size. Predefined reports, scheduling, and dispatch functions all use the same database. This highly sophisticated information system supports the encounter billing process. Moreover, because our information system is fully integrated into the scheduling process on a real-time basis, we track all denials of care and allow for ongoing monitoring of transportation policy as well as review for excessive utilization. Operational procedures have been created and followed to ensure ongoing compliance consistency with the transportation process.
The reporting capabilities of the transportation software have enabled LCP to maximize the transportation provider’s trip efficiency. LCP has been able to decrease the cost per trip and has passed the savings on to the customer. LCP’s process has enabled state and MCO/HMO customers to focus on wellness programs and utilization trends.
LCP’s dispatch system coordinates all statewide trips down to an individual trip and driver level. This allows for the computation of trips taking into account the capacity availability of NEMT provider vehicles and staff to maximize efficiency.
LCP’s dispatch system has the ability to utilize city bus systems.
LCP has the experience and the ability to incorporate its own fleet in order to augment a state’s existing NEMT provider base. This reduces the number of no shows and missed trips to a minimum and greatly enhances the member’s transportation experience.
LCP manages the cost of transportation itself in several important ways:
- LCP utilizes a combination of NEMT providers and its own drivers to meet a large majority of the regular trips, and urgent care trips for higher-density urban areas. Also, LCP utilizes its own drivers for some after hour and long-distance trips in rural areas where 24-hour service may not be available.
- LCP coordinates with other transportation providers statewide to provide regular local trips to members in more rural sparsely populated areas and urgent care trips in the urban areas.
- LCP can offer bus passes and mileage reimbursement for transportation alternatives in some metropolitan areas if this option is desired by the MCO/HMO. This includes educating patients as to public transit schedules and routes. Our goal is to focus our resources on providing high-quality, timely transportation for those patients who require it, while still providing alternatives to those who need some help in reaching their provider appointments.
- LCP takes special care in organizing transportation for its members with special need. By using mini-vans and coordinate schedules with patients and dialysis centers, LCP is able to schedule and combine trips to maximize transportation efficiencies.
LCP’s business process reduces the administrative burden of operating a statewide transportation system. This process is accomplished through the use of Encounter Data (information obtained from the members to create a trip). The LCP information system maintains the majority of those data elements needed for encounter data at the time of trip scheduling. The remaining data elements associated with the trip will be supplied on the manifest report from the transportation vendor/driver via a HIPPA approved communication vehicle. Completed trip data will be posted electronically to the MCE/HMO by LCP or by other means of transmission of the customers choosing.
One of the most important value added services that LCP will offer to MCO/HMO Programs is the ability to manage utilization for a traditionally challenging member population. This management expertise will allow LCP and MCO/HMO Programs the ability to provide better service. Managing this population requires a trained staff that understands the Medicaid rules and consistently enforces them. Therefore, staff members are trained to identify certain situations that could be potential avenues for abuse.
LCP utilizes a proprietary information technology transportation system based on a relational database that will provide our utilization management staff with the necessary reporting capabilities to track and react to potential abuse. The technology allows the staff the ability to identify high utilization members and providers. The system also allows the staff the ability to confirm scheduled appointments. This confirmation process helps to reduce the number of fraudulently scheduled trips.
Next, the staff is able to identify high non-emergency hospital emergency room trips. This will free up emergency room staff to better service the patients that present with emergency symptoms. Also decreased utilization to the emergency room would significantly reduce health care cost per member for the MCO/HMO.
Finally, the fact that LCP can see all utilization in any defined area helps LCP and its customers to detect certain patterns of abuse and over utilization of transportation services. The system can track members that have a pattern of no-shows, cancellations, excessive trips to the same provider that are outside the norm, out-of-state trips, and long distance trips.