Provider Alerts

Ground Emergency Medical Transportation and Non-Emergency Medical Transportation Mileage and Address Documentation Requirements

Health Plan would like to extend additional guidance from the previous communication sent on June 26, 2024, regarding Ground Emergency Medical Transportation and Non-Emergency Medical Transportation billing procedures.

As you know, accurate documentation is crucial for seamless processing and timely reimbursement.

1. Mileage Documentation:

• Ensure all claims include complete origination (pick-up) and destination (drop-off) addresses, as well as the drop-off location name.
• This information is required and is essential for the validation of services rendered and must be clearly detailed in the claim submission.

2. Billing Notes:

• For paper billing, you may include the necessary mileage documentation within Box 19 or as a separate attachment when submitting the claim.
• For electronic billing, you should utilize field 2310E for entering the required origination (pick-up) and destination (drop-off) addresses. If you have questions about electronic submissions, please reach out to your selected clearinghouse for further clarification.

3. Claim Rejections:

• Please be advised that, as of June 18^th, claims missing any of the required fields outlined above will be rejected at the clearinghouse level.

Claims that are rejected will need to be corrected and resubmitted to ensure proper processing and timely payment.

If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org