While there are no set standards across the United States, have in mind that how you choose to charge for NEMT services for your private transit company will vary depending on numerous factors, especially who is expected to pay for those services.
Depending on the situation, you could be dealing with payments from insurance providers or private pay clients. However, regardless of who’s paying, you need to analyze a variety of costs to determine your rates.
Non-Emergency Medical Transportation (NEMT) is a transportation service made available to individuals who are not in an emergency but will require more medical assistance and well-tailored equipment than normal transportation options can provide.
According to reports, around 3.6 million Americans do not make it to their medical appointment or have to deal with delayed care simply because they lack access to proper transportation. For these special individuals, NEMT services are a vital aspect of living.
Before you start considering how much to charge for your NEMT services, it is pertinent you understand that a good percentage of your business will come from a broker. To a very large extent, the broker will be deciding how much they will pay you for the services offered.
Howbeit, once in a while, you have to negotiate special trip requests such as something outside of your normal coverage zone. Note that for such requests, you have to analyze the exact circumstances and increase the rates accordingly.
It is also necessary to note that a good number of NEMT providers charge a base fee depending on the exact type of transportation service needed: ambulatory, wheelchair, or stretcher. Aside from the base fee, some NEMT providers also charge per mile as well, and these mileage rates will also vary depending on the proximity of the patient.
If round-trip service is required, these providers will charge a wait time fee coupled with the base rate and mileage charges. Most often, these charges are based on 15-30 minute blocks. If an extra attendant will be joining in on the NEMT trip, a charge may be required as well.
Howbeit, while non-Emergency Medical Transportation services are vital for many Americans, the best way for these businesses to keep track of payments and costs to ensure a viable pricing strategy is by using a NEMT software that offers a billing component.
Note that this way, you can easily show patients and providers how exactly their costs came to be, and you can ensure that your information is all in one place.
Factors That Will Influence How You Charge for NEMT Services
Just like it was noted above, there are several crucial factors you should consider to determine how to charge for NEMT services for your private transit insurance. Those factors include;
Just like with any other business, there are fixed costs a private transit company offering NEMT services will have to put up with. These are expenses that don’t change like lease price, cost of a vehicle, and hourly wages. They are more or less the first costs a private transit company should consider, especially since they barely change.
Unlike fixed costs, these are costs that increase as the private transit company grows. For example, the cost of business insurance will surely increase every time you add another vehicle to your NEMT service package, and a higher number of vehicles on the road also entails that your vehicle maintenance costs will also increase.
Average Market Price
When analyzing how to charge for NEMT services, it is pertinent that you become familiar with average prices for NEMT Services in your area. For instance, a NEMT business in New York City can charge around $21.25–$67.50 per trip, depending on the classification of the patient they pick up, and $2.25 per mile on top of that.
But in other states, like Illinois, NEMT providers are paid only on a per-mile basis. This factor is very vital because if you charge too little, you won’t make any money in NEMT. If you charge excessively, potential customers will look to the more affordable competition.
Truth be told, this will genuinely depend on how many other NEMT services are in your area. For instance, if you’re the only private transit company offering NEMT services, the demand for your services will be high. However, if there are others in the same area, you’ll have to look for innovative ways to differentiate your business and sell it as the most ideal choice in the market.
Mode of Transport
Just like it was noted above, what you choose to charge for your NEMT services will depend on the services required by your client. Note that your patients will require different modes of transport, including ambulatory, wheelchair, and stretcher.
The prices for each will also vary based on weekdays and holidays, and if you’re in the only NEMT Company in the area, it gives you the leverage to charge higher prices for the service.
Structure of Non-Emergency Medical Transportation Rates
Aside from the factors noted above, there are fee structures in this line of business that will surely influence what you charge for your NEMT services. Think about the following fees as you begin planning your pricing structure:
This is the fee you charge just for making the initial pick-up. It will fluctuate based on the mode of transportation.
Per Mile Rate
Whether you intend to charge per mile or leverage a minimum charge, it is a personal business decision. However, if you aren’t doing many long trips, it might be ideal to settle for a flat rate so you aren’t losing money.
Weekend and Holiday Fees
A good number of NEMT businesses charge a bit higher for weekend or holiday trips because those days don’t fall within typical operating hours, and they won’t see that much business.
No Show Fee
Just as the name implies, this is the fee charged when a patient fails to show up for their trip. This is a way to make sure you aren’t wasting money on gas and mileage if a ride turns out to be a no-show.
Minimum Charge and Flat Rate Fee
Have it in mind that utilizing a minimum charge or a flat rate fee will ensure well-noted profit per trip. This is a perfect option especially if you don’t have many competitors in the same area.
NEMT businesses most often operate with funding from Medicaid; the annual Medicaid expenditure for transportation services is around $3 billion. However, since the pricing for NEMT Medicaid reimbursements differs from state to state, the pricing structure and amount of money NEMT providers can make also varies.
However, once you look at all the factors that influence your NEMT rates, you can easily understand what prices will earn you the most business and, in turn, a good amount of profit.