How it runs for NEMT and medical transportation companies
Facility payments are applied by invoice number and remittance advice, and private-pay receipts to the rider's statement. Unapplied cash is worked within two business days so the aging by broker and customer is real.
What is cash application?
Cash application means matching money received from customers to the invoices it pays and recording that in the accounting system. It covers bank receipts, checks, lockbox files, card payouts and remittance advices, including partial payments, deductions and payments with no reference. Done well, the aging is accurate and no customer is chased for an invoice they already paid.
What we handle for NEMT and medical transportation companies
- Apply broker remittances trip by trip with short pays and denials coded by reason
- Post recoupments and adjustments against the original trip rather than as new items
- Apply facility payments by invoice number and remittance advice, noting deductions
- Match private-pay checks, ACH and card receipts to rider statements
- Clear unapplied cash within two business days with a documented reason
The KPI that matters here
Every broker and facility payment applied within two business days of deposit, with unapplied cash under one percent of receipts.
NEMT compliance notes
Broker contracts (Modivcare, MTM and regional brokers)
Each broker contract defines rate tables by trip type and mileage band, documentation required for payment, the dispute window and audit rights. We keep the current rate table in the billing workflow, check remittances against it, and log every dispute with its deadline so revenue is not lost to a missed date.
HIPAA
Trip records identify riders, pickup addresses and often the treating facility, which makes them protected health information. We sign a BAA, staff are HIPAA-trained, portal access is role-limited with MFA, and ledger entries reference trip or invoice numbers rather than rider names.
State Medicaid NEMT rules
States set driver background-check, vehicle inspection, trip-log and record-retention requirements for Medicaid transportation, and brokers pass those obligations through their contracts. We file supporting cost records so a state or broker audit can be answered from the books, and we flag lapses in insurance or inspection renewals that would suspend billing.
Worker classification
How drivers are paid and controlled determines whether they are employees or contractors under IRS and state tests. We book pay according to the classification you and your counsel have chosen, track 1099 settlements separately from W-2 payroll, and prepare the year-end 1099-NEC data for owner-operators.
NEMT software we work in
- QuickBooks Online
- Gusto
- ADP
- Bill.com
- TripMaster
- RouteGenie
- Modivcare provider portal
- MTM provider portal
- All 50 platforms
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Frequently asked questions
How do you apply a broker deposit to hundreds of trips?
The broker's remittance file lists each trip with the amount paid and any adjustment code. We import it, match each line to the trip in your dispatch or billing system by trip ID, apply the paid amount, and tag short pays and denials with the broker's reason. The remittance total then agrees to the bank deposit and the receivable by broker reflects what remains.
What do you do with a facility payment that has an unexplained deduction?
We apply the payment to the invoices it names, record the deduction as a short pay against the invoice it appears to relate to, and open a follow-up item for the facility's accounts-payable team. Our billing agents contact them under your name to obtain the reason, and the balance is either corrected, rebilled or written off with documentation.
How do recoupments affect the books?
A recoupment reduces a later remittance to recover an earlier overpayment or a trip the broker later denied. We post it against the original trip so the history is intact, and we open a dispute if the recoupment appears wrong and is still inside the window. Booking recoupments as unexplained bank shortfalls is one of the most common errors in NEMT books.
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