Basics
Levels of Service
Policies 1.0
Policies 2.0
Facilities
100

Type of Insurance NJ DMAHS is under.

What is Medicaid?

100

Assign this level of service when a member is using the Mass Transit Program.

What is Mass Transit?

100

When a discharge does not have a linked provider assign to the _______.

What is the '*Discharge' bucket?

100

Mileage Reimbursement Notice Requirements.

What is "Before the member is seen by the doctor."

100

The lowest level of service assigned for members leaving from a nursing home or assisted living facility.

What is Ambulatory/Mav?

200

Treatment types that can bypass the notice requirements and verification process when the location is in the rolodex.

What is Dialysis, Chemotherapy, Radiation, or Wound Care?

200

The level of service assigned when the member can walk but has a walker they need the driver to collapse and place into the vehicle.

What is Ambulatory/MAV?

200

Policy where the member cannot travel over 20 miles.

What is Closest Provider Certification (CPC)?

200

Amount of courtesy trips provided when a basic Closest Provider Certification (CPC) request is pending.

What is 'none'?

200

Individuals allowed to request a discharge.

What is facility staff?

300

NJ DMAHS Notice Requirements.

What is '2 business days before 2pm'?

300

The following information needs to be requested when booking this level of service:

Manual or Electric

Weight

Height

Amount of Steps

What is Wheelchair levels of service?

300

Amount of courtesy trips provided while an MNF is pending.

What is '20 business days'?

300

Substance abuse trips are exempt under the CPC policy with a ____ mile limit.

What is 30?

300

Check this to assign a specific provider if the facility states they have a linked provider.

What is the "Nursing Home and Treatment Facility Link Up Sheet"?
400

Information needed to check a members eligibility?

What is 'the members name, date of birth, and Medicaid ID number (optional)'?
400

Qualifications for members using Special Rate Wheelchair (SRW) level of service.

What is:

2 Steps with 200lbs (2 for 2 Combo)?

3 Steps regardless of the weight?

400

A Medical Necessity Form (MNF) is needed to _________________.

What is 'upgrade or downgrade a members level of service'?

400

When a member uses the Mass Transit Program and schedules 5 or more trips, they will receive this ______.

What is 'a bus pass'?

400
Standing Orders for treatment types other than dialysis must be requested by the facility through ________.

What is a 'fax'?

500

To properly _______ a trip, the A-leg portion of the trip needs to be entered.

What is 'deny'?

500

The level of service assigned when the member needs a nurse to monitor their equipment during the trip.

What is Specialty Care Transport (SCT)?

500

A Medical Necessity Form (MNF) must be on file and approved before we can provide livery service when a member is using this Program.

What is Mass Transit?

500

Steps followed prior to requesting a Closest Provider Certification (CPC) request.

What is checking the rider notes and checking the exemption list?

500

Transportation is not covered for members traveling by stretcher to a hospital for the following when a member has __________:

Mental Health

Wound Care

Cancer Care

What is Med B?