If you are managing drivers and trying to figure out how to manage tolls for medical transport fleets, there are several considerations that need to be addressed to ensure success. One of the complicated questions that needs to be addressed is who actually pays for the toll costs, especially when there are costs relating to home health visits, medical couriers, and more.
Why Tolls Are a Hidden Cost for Healthcare Fleets
While tolls affect fleets in all industries, there can be hidden costs affecting health care companies and individuals specifically. The types of medical fleets that are affected the most include:
- NEMT providers
- Home health and in-home care
- Medical couriers
- Lab logistics
These fleets have a high volume of trips, and they are constantly moving across fixed, repeated routes. As a result, the toll costs add up much faster compared to fleets that just have occasional trips.
Too often, the toll fees are the missing line item in the fleet budget. These expenses fall through the cracks because more focus is placed on mileage tracking, billing, and broker payments.
How Tolls Are Handled for NEMT Medicaid Trips
Check multiple Medicaid provider manuals, and you will see that they vary in how (or whether) toll and parking reimbursement is handled. The determining factor in whether the toll is covered in the reimbursement usually comes down to whether the provider is calculating reimbursements based on mileage or per trip. Mileage costs don’t calculate things like toll fees, while per-trip can include toll costs more effectively.
Also, the way the trip is completed will determine whether tolling fees are included. For example, if it is a broker-contracted trip through a company like Modivcare or MTM, then the broker will usually absorb the toll costs. But direct-billed trips are often handled differently.
Keep in mind that there may be state-by-state variations. So, if you are managing toll costs for a healthcare fleet, then it’s essential that you check the specific rules for each market where the fleet is operating.
Who Pays for Tolls on Non-Emergency Medical Transportation in Home Health?
Home health care fleet toll expenses sometimes end up on the caregivers, especially since the IRS standard mileage rate usually doesn’t cover the actual toll expenses. This number only accounts for fuel costs and wear and tear.
On the other hand, employee-reimbursement or company-owned fleet models have different practices in place for handling tolling fees and other trip-related costs. The key is to ensure that you have a consistent system in place for the entire team. It can be a big challenge to capture toll receipts consistently, especially when there are dozens of caregivers working for the company.
The Multi-State Compliance Challenge for Medical Fleets
When a fleet is moving through different areas and jurisdictions, a robust system is critical to ensure that everything is aligned with various rules and payments. Working with multiple toll authorities means that things can get complicated.
This complexity compounds because of license-plate tolling and interoperability across state lines. Without a proactive approach and a proven system, it can result in complications and unexpected fines from toll violations. In some cases, an insufficient system for toll management could even trigger registration holds on the vehicles, which can have serious consequences for patient-transport vehicles during the most critical times.
What To Do About Toll Violations (Managing and Preventing Violations)
One of the biggest headaches in managing a fleet is dealing with toll violations that are coming through. Some of the most common causes of these violations include:
- Wrong-plate reads
- Retired vehicles that are still tied to active accounts
- Empty transponder balances
These issues can be simple to fix, but result in compounding fees when they are left unaddressed. Early violations get worse over time, especially when the administrative fees turn into more severe penalties…and eventually result in full collections if they are left unpaid.
Building a Workflow That Protects Reimbursement
As you are learning how to manage tolls for medical transport fleets, it all comes down to building a workflow that aligns with your team. The simplest solution is to use a consolidated dashboard and a single point of contact for all of the toll authorities that you are working with. Instead of having all of the information scattered in files, paperwork, and messages, it’s critical to have a centralized system where everything is moving through in an organized manner.
Not only does a toll management dashboard consolidate the process and simplify your administrative work, but it also gives you itemized, audit-ready records so that you can easily meet billing requirements. Medicaid and brokers usually have strict rules that must be followed, and these reports solve this issue.
Additionally, set up alerts so that you can catch potential issues before they become bigger problems. For example, these alerts can trigger when there is a low balance in the transponder account or if a violation has occurred. Then, you can act immediately to solve the problems and avoid fees and penalties later on.
FAQs
Are tolls reimbursable for NEMT trips under Medicaid?
Reimbursements vary, depending on the state’s Medicaid provider manual and how reimbursement is structured. Some states use mileage (which doesn’t account for tolls), while others reimburse on a per-trip basis.
Who pays for tolls on non-emergency medical transportation?
Toll payment practices vary, depending on the provider and contract type. Trips that are either contracted by brokers or billed directly often handle toll costs differently.
Are ambulances and medical transport vehicles exempt from tolls?
The general rule of thumb is that only real emergency vehicles qualify for toll exemptions. But NEMT and home health vehicles typically don’t qualify for exemptions, and the fees need to be paid.
A Proven System for Healthcare Toll Management
At Innovative Toll Solutions, we offer the solutions you need for managing your tolls. Our system gives you itemized, compliant toll records that can be used for various types of medical and healthcare fleets.
For more information about fleet toll management that will work for your team, contact us today to discuss your needs.