If the trip cost of a claim in incorrect, remove it from the packet by pressing the “Delete” button next to the claim. All changes to claims information must be made and verified prior to submission. Once submitted, changes may not be made to the cost. Contact the Transportation Helpdesk at 1-877-892- 3997, should any errors occur. ETD Electronic Trip Download (ETD) Instructions Through MTM’s website, transportation providers may utilize the ETD tool to download assigned trips. This application requires internet access and Microsoft Excel software. To download trips electronically, providers must: Log on to the website using their unique log-in information Select “Electronic Trip Download” from the menu options on “Create New” and insert the desired trip dates Hit “Save” File will be downloaded and made available for access via the provider’s computer Keep any changes made to the file by saving it to the computer NET Provider Claims Appeals MTM’s appeals process transportation providers an opportunity to appeal any denied claims. Please note that trip cost changes will not be considered after a trip has been claimed and may not be appealed. MTM will maintain a procedure for reviewing Complaints and grievances made by NET Providers. MTM will notify DOM within one (1) business day of receipt of the complaint. The NET Provider shall be allowed fifteen (15) days to request a review of the decision by the MTM or DOM or both. Failure to request a review within fifteen (15) days shall be a waiver of the NET Provider’s right to request a review. Each complaint or grievance shall be assigned a unique tracking number. MTM’s procedures shall be submitted to DOM in writing and approved in writing by DOM. MTM will submit the complaint and grievance protocol to DOM thirty (30) calendar days prior to contract start date for review and approval. The procedures shall provide for prompt resolution, and ensure the participation of individuals who have
Column E displays the beneficiary’s age: (40) Column F show the beneficiary’s phone number; (1234567) Column N shows the vehicle type, where C = Cab and P = Para-lift Column M shows the trip status; (S1 – see page 29 for definitions of trip status codes) NOTE: Columns can be added or deleted by right-clicking with your mouse on a column and selecting Insert to add a column, or Delete to remove a column. Round Trips Each round trip will have two legs: the “To Leg” and the “From Leg.” Each trip has a “Trip Number,” the “To” and the “From” legs are identified by the letter A or B at the end of the trip number. Example: To Leg = MTMA1202222A: The appointment time of “Leg A” indicates at what time the beneficiary to be at the appointment. From Leg = MTMA1202222B: The appointment time of “Leg B” indicates at what time the beneficiary will need to be picked up for the return ride home. If “Leg B” has a zero under appointment time, this indicates that the return time is a “will-call” and that the beneficiary “will-call” when they are ready to be picked up. Multi Leg trip (3 Leg Trip) trips will have individual trip numbers and have a letter A at the end of the trip number; for example: To leg = MTMA1202222A To leg = MTMA1222223A From leg = MTMA122224A Three-legged trips will not have a “B” leg assigned.