Texas Glossary of Terms
The following terms are pertinent to Texas NEMT services. All terms are explained per MTM’s definitions.
Practices that are inconsistent with sound fiscal, business, or transportation practices, and result in an unnecessary cost to the Medical Transportation Program (MTP), or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for NEMT services, or do not meet standards required by contract, statute, or regulation. It also includes client practices that result in unnecessary cost to MTP.
An unexpected and unfortunate medically important bodily event causing loss or injury to a person. Accidents may involve loss of property (e.g., automobile).
A specially equipped vehicle for transporting convalescing or people with disabilities in nonemergency situations.
An adult or service animal that accompanies a person receiving a ride to provide necessary mobility, personal or language assistance during the time that transportation and health care services are provided.
Motorized winch and ramps for loading passengers. Designed to provide safe transportation for people with body weight in excess of standard equipment limitations (800 lbs).
Transportation vendor responsible for:
- Establishing a network of providers
- Operating a central call center
- Implementing screening to validate eligibility of recipient and trip for coverage
- Determining the most appropriate mode of transportation
- Maintaining quality assurance
- Reporting encounter data
- Paying transportation claims
According to §380.301(7), a trip that a client cancels four or more hours before the trip takes place. Cancellation is also a verbal notification from a client’s advocate using the MTP toll-free number prior to the scheduled medical transportation service which indicates that the particular service is not needed.
People covered by Medicaid, Children with Special Health Care Needs (CSHCN,), and Transportation for Indigent Cancer Patients (TICP) programs who do not have any other means of transportation to covered, medically necessary health-care services.
Curb to Curb Service
Transportation from curb at origin to curb at destination. This service includes providing assistance, as required, to passengers entering and exiting the vehicle.
Transportation that involves using contractor dispatched vehicles in response to requests for individual or shared one-way trips.
Service provided to people who need help to move safely from the door of the vehicle to the door of the pickup point or health-care location.
A service that includes providing medical care while individual is being transported.
Excessive Trip Time
Time that results in at least two hours over the standard travel time.
Designated public transportation on which a vehicle is operated along a prescribed route according to a fixed schedule.
Refers to the class action lawsuit: Linda Frew, et al. v. Kyle Janek, et al., U.S. District Court, Eastern District of Texas, Paris Division, Civil Action No. 3:93CV065; brought on behalf of children enrolled in Texas Medicaid through age 20
Frew Class Members
Refers to Medicaid clients, birth through age 20, who have not received all of the Texas HealthSteps services to which they are entitled, unless the services were declined (see Frew).
An allegation of an incident substantiated by commission records, transportation or medical provider records, and witnesses of the incident to the satisfaction of department staff.
Long Distance Trip
Transportation by demand response beyond a person’s managed care resident and adjacent region for the purpose of receiving health-care services that are not available in the person’s resident region.
Public transportation by bus, rail, air, ferry, or intra-city bus either publicly or privately owned, which provides general or special service transportation to the public on a regular and continuing basis.
Network of Providers
An entity or group of providers set up by a transportation broker to transport eligible recipients to authorized health-care appointments.
A person who does not respond within ten minutes of the time the transportation provider arrives at the designated pick-up point and scheduled time and announces its presence; or a transportation provider who fails to arrive at the designated pick-up point and time.
One-way trip is transportation of a person from point of origin to destination. (A) Origin – The location at which the contractor is authorized to pick up the person at the start of the trip. (B) Destination – The location or point to which a person has been authorized to travel to obtain medical services.
Assistance which enables a passenger to walk, enter or exit a vehicle, or transfer from a wheelchair. This does not include lifting or carrying a person.
Routine Medical Transportation
Prior authorized medical transportation trips that do not have priority status to and/or from a facility where health-care needs will be met.
A trained guide dog, signal dog, or other animal to provide assistance to a person with a disability.
A demand response transport for multiple passengers traveling in the same direction with appointments set up within one hour of each other.
Special Needs Transportation
Medical transportation to and/or from a client’s county of residence and beyond the adjacent county, where healthcare needs will be met and the appropriate health care service(s) are not available locally.
Service for people who cannot be transported in a taxi or wheelchair van but do not require the medical services of an ambulance. This is for people who generally cannot use a seat in the vertical position and must use a stretcher during transport. Person must be medically stable to be transported by stretcher service.
Those people who have repeated scheduled appointments to the same health-care provider, such as dialysis patients. These people may be approved for a six-month period without calling the call center for prior authorization. Appointments other than the subscription plan must follow the 48 business hour advance notice.
Telecommunications device for the deaf.
Teletype writer, scribing a telegraphic apparatus by which signals are sent by striking the letters and symbols of the keyboard of an instrument resembling a typewriter and are received by a similar instrument that automatically prints them in type corresponding to the keys struck.
A request for nonemergency medical transportation for illnesses or injuries of a less than serious nature than those constituting emergencies but for which treatment is required to prevent a serious deterioration in recipient’s health and for which treatment cannot be delayed without imposing undue risk on the qualified recipient’s well-being.