MTM partners with medical facilities throughout ten counties in Minnesota (Hennepin, Ramsey, Dakota, Washington, Isanti, Chisago, Anoka, Sherburne, Stearns, and Wright) to ensure seamless, successful transportation delivery to Medical Assistance recipients. Our Care Management department was developed for the sole purpose of working with medical facilities that serve recipients. For example, our Care Management team helps facilities by:
- Providing a dedicated point of contact
- Handling difficult or out-of-the-ordinary NEMT requests
- Managing meals and lodging services, as needed
Forms and Other Resources:
- Transportation Request Form
- Transportation Request for Refugees Form
- Level of Need (LON) Form
- Gas Mileage Reimbursement Trip Log
- Gas Mileage Reimbursement Trip Log (Spanish)
- Gas Mileage Reimbursement Trip Log (Somali)
- Gas Mileage Reimbursement Trip Log (Hmong)
- Gas Mileage Reimbursement Trip Log (Karen)
- Ancillary Services Form
- Ancillary Services Form (Spanish)
- Ancillary Services Form (Somali)
- Ancillary Services Form (Hmong)
- Ancillary Services Form (Karen)
- Minor Parental Authorization Form
- Minor Parental Authorization Form (Spanish)
- Minor Parental Authorization Form (Somali)
- Minor Parental Authorization Form (Hmong)
- Minor Parental Authorization Form (Karen)
- Medically Necessary Attendant Form
- Medically Necessary Attendant Form (Spanish)
- Medically Necessary Attendant Form (Somali)
- Medically Necessary Attendant Form (Hmong)
- Medically Necessary Attendant Form (Karen)
- Medically Necessary Distance Form
- Medically Necessary Distance Form (Spanish)
- Medically Necessary Distance Form (Somali)
- Medically Necessary Distance Form (Hmong)
- Medically Necessary Distance Form (Karen)
- NEMT Services Brochure
- NEMT Services Brochure (Spanish)
- NEMT Services Brochure (Somali)
- NEMT Services Brochure (Hmong)
- NEMT Services Brochure (Karen)
- Mileage & Access Services Brochure
- Mileage & Access Services Brochure (Spanish)
- Mileage & Access Services Brochure (Somali)
- Mileage & Access Services Brochure (Hmong)
- Mileage & Access Services Brochure (Karen)
In Minnesota, MTM provides NEMT for recipients who are one of the following:
- Enrolled in Medical Assistance
- Enrolled in state-only funded Medical Assistance benefits due to residing in an Institution of Mental Diseases (IMD)
- A MinnesotaCare enrollee under the age of 21
- A pregnant woman enrolled in MinnesotaCare
- Enrolled in Refugee Medical Assistance (RMA)
Recipients must be attending a covered medical service and have no other way to get there. If the recipient can drive themselves to a covered appointment, or if a neighbor, friend, relative, or voluntary organization is able to give them a ride for free, they cannot get a ride through MTM. However, they may be eligible for mileage reimbursement.
Call us at 866-467-1724 at least three days before the recipient’s healthcare appointment. With the exception of hospital discharges and urgent trips, if you call with less notice and the trip is not urgent, the recipient may need to set up their visit for a different date. We schedule routine trips Monday through Friday from 7 a.m. to 6 p.m. Urgent rides can be scheduled after these hours, 24 hours a day, seven days a week. Medical facilities may also schedule trips through SMP and send faxed requests to 651-645-9627 at any time.
Call us at 866-467-1724 a minimum of 24 hours in advance when possible.
The customer service representative will note the trip and cancel with the transportation provider.
Cancellation policy: Excessive cancellation will result in a temporary suspension of transportation benefits.
An urgent trip is an unscheduled episodic situation in which there is no immediate threat to life or limb, but the recipient must be seen on the day of the request and treatment cannot be delayed until the next day. This may also include hospital discharges.
MTM does not provide emergency transportation that pertains to life threatening medical situations, significant trauma, comas, shock, uncontrolled bleeding, respiratory distress, poisoning, drug overdose, and any other situation where immediate medical relief or treatment is necessary. Please call 911 in the case of a medical emergency.
If a recipient says s/he is unable to utilize public transportation or mileage reimbursement, a healthcare provider will be required to fill out our Transportation Evaluation Form. This form communicates the recipient’s actual needs to MTM for appropriate mode assignment.
MTM can schedule recurring trips, which eliminates the need to schedule each trip individually. MTM schedules recurring trips for dialysis for up to six months at a time. Trips for all other standing order appointments can be scheduled for up to three months at a time. Recurring trips may be scheduled through the SMP, or by calling 866-467-1724.
Please use the actual time the recipient needs to arrive at the facility. For the return ride, please use the actual time the recipient will be ready to leave the facility. If the return time is not known at the time of the reservation, MTM will assign the return trip as a will-call trip. In this case, you will call MTM when the recipient is ready for their ride home. A transportation provider will arrive within one hour following a will-call request.
We want to always provide excellent service. Call MTM’s We Care line at 866-436-0457 if you or a recipient have a complaint about the service you received. We will follow up on all complaints. The We Care line is answered from 7 a.m. to 5 p.m., Monday through Friday; if you call after hours, you can leave a voicemail and we will contact you the following business day.
You may also fill out our convenient online form, or write to MTM at:
Attn: Quality & Compliance
16 Hawk Ridge Drive
Lake Saint Louis, Missouri 63367