Communities without barriers

w w w. mt m - i n c. n e t

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 dis-

advantaged 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 increas-

ing access to healthcare.

Through our diverse product off erings, MTM helps

clients meet challenges that are often left unful-

fi lled while collaborating to align incentives, re-

duce costs, and increase satisfaction. This approach

directly supports our core mission of increasing the

wellbeing of the populations we serve by remov-

ing community barriers, promoting independence,

and improving health outcomes.

MTM Footprint

New Jersey

New YorkR.I.

Mass.

Conn.

N.H.

Maine

Pennsylvania

Del.Md.Washington D.C.

Vt.

Washington

ArizonaNew Mexico

Texas

Oklahoma

KansasColorado

Utah

Nevada

California

Idaho

Montana North Dakota

South Dakota

Nebraska

Minnesota

Iowa

Missouri

Arkansas

Mississippi

Louisiana

Florida

Georgia

Tennessee

Wisconsin

Illinois Indiana Ohio

Michigan

Kentucky

Wyoming

Virginia

VirginiaWest

CarolinaSouth

Ocean

NorthAtlantic

North

OceanPacific

Hawaii

Oregon

North Carolina

MTM headquarters

MTM customer service centers

MTM Business offices

Indicates states in which MTM operates

Across the country, MTM’s clients gain process effi ciency, cost containment, and

improved customer service with our proven management methods. Since be-

ginning our operations in Missouri in 1995, MTM has quickly expanded nation-

wide. With our vast presence, MTM has the ability implement new programs and

provider networks seamlessly and effi ciently.

Every year we schedule more than ten million trips and

service encounters for eight million members. Through

our nine customer service centers, we fi eld approximately

eight million calls with the utmost attention to high quality

customer service. We currently have a varied client base,

including contracts with:

Managed care organizations and health plans

State and county governments

Transit agencies

Area Agencies on Aging

Health and human services departments

Care Management

As one of the fi rst NEMT managers

to deploy a care management ap-

proach, we provide person-centric

care, enhanced coordination, and

positive outcomes in each of our

service areas. In particular, our Care

Management department gives ex-

tra attention to members with high

risk medical needs, providing exten-

sive care coordination to ensure their

health and wellbeing.

Customer Service

MTM’s contact 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 mem-

bers with exceptional customer ser-

vice while delivering value to clients.

Network Management

By building and maintaining

networks of high-caliber service

providers, MTM off ers consistency

and quality in all areas of network

management—from recruiting,

negotiating rates, contracting, and

credentialing to reviewing claims

and processing payments—to es-

tablish solid networks. Our methods

ensure we meet the needs of clients

in both urban and rural locations.

Advantage

24 7365

Technology

Technology is the heart of MTM

operations, enabling automation,

protocol adherence, error reduc-

tion, 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. Addition-

ally, our contact centers are linked,

preventing downtime and allowing

automatic call rerouting.

Fraud & Abuse Reduction

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 verifi es member eligibility,

monitors service appropriateness,

and conducts regular audits to

ensure members receive necessary,

appropriate services that are

benefi cial to their overall health.

Quality

MTM strives to provide the high-

est level of service by demand-

ing 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 eff orts by monitoring

service, performing audits, conduct-

ing weekly satisfaction surveys, and

addressing issues immediately.

Transportation Management

Care Coordination

Ambulance

Contact Center Services

Assessments & Travel Training

Services

Transportation Management

From sedan and ambulatory transports to higher levels of service such as wheelchair

lift and stretcher van, MTM schedules more than ten million trips nationwide each

year. Through our industry-best operating model that leverages comprehensive

network management, innovative technology, extensive cost savings, and excel-

lent customer service, we continually deliver effi ciency 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 diffi cult

transportation challenges and is a true one-stop transportation solution.

Non-Emergency Medical TransportationMTM developed one of the fi rst NEMT brokerage pro-

grams of its kind in Missouri in 1995, and has remained a

clear leader in NEMT management. We understand the

complexities of serving Medicaid and Medicare popula-

tions, including frail, elderly, and other transportation

disadvantaged passengers, and off er proven solutions

for coordinating their needs effi ciently.

Paratransit ServicesAs demand for Americans with Disabilities Act (ADA)

paratransit services continues to grow while budgets

tighten, innovative management is a must. MTM’s bro-

kerage model centralizes scheduling, assigns passengers

to lower modes of transportation, and maximizes un-

dedicated, existing networks of vehicles to contain costs

while increasing consistency and quality.

Worker’s CompensationGetting injured workers back to work begins by

getting them to the medical services they need.

MTM has a robust network of national transporta-

tion providers that ensures injured workers receive

timely, quality access to the care that will get them

back on their feet.

Special Needs & EducationFor school districts facing decreased budgets and

fl uctuating enrollment, coordinating transporta-

tion can be a costly, time-consuming process. By

outsourcing transportation to MTM, school systems

can stretch their valuable resources without sacrifi c-

ing the quality, safety, or reliability that is important

when transporting children.

MTM is your trusted partner for keeping members in place, in their own home or

community setting. Transforming the delivery of home and community based

services (HCBS) to serve a variety of populations, including individuals with men-

tal illnesses, intellectual or developmental disabilities, and/or physical disabilities,

is becoming more important. By providing services that promote independence

and remove barriers to care, MTM helps managed care organizations and

agencies improve members’ overall health and wellbeing while simultaneously

delivering cost savings.

Home & CommunityBased Services

Network Oversight

Network oversight can be a large

challenge. More so than any other

HCBS coordinator, we off er exten-

sive processes for managing service

provider networks. To ensure mem-

ber safety and satisfaction, each

vendor undergoes our rigorous cre-

dentialing process, inclusive of back-

ground and certifi cation checks.

We can even help you design these

credentials to meet plan require-

ments. We also ensure services are

rendered in a safe, timely manner by

performing regular fi eld monitoring

and inspection activities.

Quality Standards

MTM demands quality from our

network providers. We realize our

clients are held to high standards by

the Centers for Medicare & Medicaid

Services (CMS), and we help health

plans meet these stringent require-

ments by keeping close watch over

HCBS provision. To be proactive in

our improvement eff orts, we moni-

tor service, perform audits, conduct

weekly satisfaction surveys, and

address issues immediately. Quality

measures and outcomes are report-

ed on a monthly basis to ensure all

appropriate standards are met.

Encounters & Billing

Our fl exible system is capable of

paying providers for their services in

a timely manner. MTM is an expert

in coordinating billing eff orts, off er-

ing clients our ability to consolidate

claims from multiple providers into

a single monthly billing statement,

which saves a great deal of admin-

istrative time. We are also familiar

with developing encounter submis-

sions for health plans, and can assist

with matching claimed encounters

with approved services and service

frequency, checking appropriate

codes, and authorizing payment.

The Three Pillars of HCBS Coordination

AmbulanceStudies 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 emer-

gency ambulance services.

Built upon our extensive experience in the transportation industry, this well-

rounded approach provides up to a 25% reduction in ambulance claims expens-

es 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 standard-

ized, 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 contact

center operations.

Claims Processing, Adjudication & Payment

Clients also benefi t 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 inaccu-

rate, 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 thor-

ough, accurate records of all claims documentation,

ensuring our staff can impartially assess the denial

while protecting against fraud. If the appeal is vali-

dated, we immediately issue payment to the provider.

Introduce newly eligible members to their health plan

Inform members of benefi t information

Provide education to reduce ER utilization

Re-enroll members close to benefi t expiration

MTM has managed customer service and member

outreach within our contact center operations since

our inception. Outside of scheduling and reservation

functions, our contact center solutions assist health

plans in reaching out to their members. Our expe-

rienced and trained representatives provide both

inbound and outbound calling to:

Contact Center Services

Experience & Reliability

Throughout our existing customer service centers,

MTM’s expert staff handles more than eight million

calls each year while maintaining industry-leading

satisfaction rates and exceeding client and NCQA stan-

dards. Our representatives are experienced in working

with members of various health plans, and are special-

ly trained to adhere to client-specifi c protocols. MTM

answers calls 24 hours a day, seven days a week, 365

days a year without interruption.

Technology & Effi ciency

With contact 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 capa-

bility to transform calls into rich, multimedia experi-

ences customized to meet specifi c needs and criteria.

Available features include automatically segmenting

and routing calls, Interactive Voice Response (IVR)

technology, and meaningful reporting.

MEMBER

What is my deductible?

Will my appointment be covered?Do you have a

primary care provider?

That is a covered service.

It is time to re-enroll.

Welcome to the plan.

How can I get a new ID card?

Open the lines of communication.

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 aff ect 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, commu-

nities, 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

Instead of considering a medical diagnosis as a fi rm eligibil-

ity determination, our assessments focus on actual function-

al and cognitive abilities. Our qualifi ed, trained evaluators

utilize recognized tools such as the Functional Assessment

of Cognitive Transit Skills (FACTS) test to determine barriers

that may impact an individual’s ability to safely and inde-

pendently access public transit. On the Move off ers several

types of assessments, including:

ADA assessments

Special needs assessments

General mobility assessments

In all cases, assessments utilize the standards and meth-

odologies of national organizations such as the National

Transit Institute (NTI) and Easter Seals Project ACTION (ESPA).

Evaluations follow a comprehensive process to accurately

determine if an individual can safely access public transit

either with or without travel training.

Travel Training

For individuals who are capable of utilizing fi xed

route bus or rail systems but may require assis-

tance before doing so, On the Move travel train-

ers provide comprehensive instruction in real-life

transit scenarios to familiarize the individual with

local transportation options. Varying travel train-

ing services—including one-on-one, classroom/

group, and train the trainer—are customized to

help individuals gain new skills, overcome fears,

and build confi dence.

For the individual trained, increased confi dence,

self-reliance, and community integration are

immediate results of learning to travel indepen-

dently. Travel training also benefi ts the clients

and communities we work with by reducing

program expenses and paratransit utilization

while increasing the use of cost-eff ective public

transit systems.

5. 1. 2. 3. 4.

Application In-Person Interview and/or Assessment

Recommendation Travel Training Transportation Scheduled

Assessment process

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