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Elizabeth M. Whitehorn, Director

Provider Notice issued 04/15/08

Prior Approvals for Participants with Unmet Spenddown

To:​ Participating Non-emergency Transportation Providers and Dialysis Centers​
​Date: ​April 15, 2008
​Re: Prior Approvals for Participants with Unmet Spenddown ​

Effective May 1, 2008, the department’s non-emergency transportation prior approval agent, First Transit Inc., will begin issuing prior approvals for participants who have not met their spenddown.  The transportation must be to or from a source of medical care covered by the department’s Medical Programs and all other prior approval guidelines remain the same.

The prior approval does not guarantee payment.  The spenddown must be met for the participant to be eligible for medical assistance and before the claim will pay.  Providers should continue to follow all current billing procedures for reimbursement. 

First Transit cannot verify spenddown status.  Eligibility and spenddown status must be verified through one of the following resources:

Questions regarding the prior approval process for non-emergency transportation should be directed to First Transit at 1-866-503-9040.

Theresa Eagleson, Administrator

Division of Medical Programs