All too often we are contacted by new providers experiencing setbacks in the early stages of launching their medical transportation business. They're discouraged because the reality of their situation is not in alignment with their expectations when they first started. Typically, their frustration grows from low sales volume, high expenses, wasted time and effort, despite the growing opportunities in our industry.
The reality is the high motivation and dreams of riches do not translate into growth and profitability when it is founded on poor or faulty information and instruction. So many of our client-providers come to us when they finally realize they fell victim to all the false hope and misinformation that's readily available online. Unfortunately, the internet is flooded with websites, bloggers, and affiliate marketers seeking to cash in on support services catering the booming elderly population.
It's so easy for someone sitting at a keyboard to claim they are an "expert" or "experienced" in any industry despite having no firsthand knowledge or experience. Therefore, the burden is on you, the well intentioned aspiring entrepreneur, to perform your due diligence and invest in thorough research and credentialing before you invest money and start your business.
The elderly population will have doubled by the year 2030. The medical industry is continuing to grow and transform. All such critical factors, and many more, are clear indication of the growing demand for non-emergency medical transportation. However, it is critical that you practice discernment on who and what you listen to. Far too many online "experts," essentially, claim all you need to do is get a vehicle and insurance and start distributing business cards and your NEMT business will thrive. Needless say, this could not be further from the truth!
If the source you are listening to does not discuss how changes in the Medicaid transportation system and various brokers are impacting the industry, how ride-sharing services are affecting your business, how to market and position your service to pursue contracts and service agreements, how to properly solicit and introduce your business to various facilities, how to effectively create infrastructure so you can grow and scale your business, and much, much more, then you need to run as fast and far away from the source of information as possible! Not only will such poor guidance and misguided leadership cost you time, money, and effort, but you will remain an independent operator versus a thriving business owner - a big difference! Your goal should be to become a thriving business owner versus an independent operator, essentially, owing your own job.
Again, the opportunity for the growing NEMT industry is obvious. The many variables associated with the growth of the medical industry and booming elderly population make starting a medical transportation business an advantageous opportunity. However, like any business, a strong foundation is critical to your successes and ensuring you are able to build a profitable asset that you can either pass onto your heirs or sell for future profit.
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Sadly, there is so much inaccurate and conflicting sources of information online that it is difficult for aspiring NEMT providers to determine which information is correct.
One of the most common questions we receive is regarding possible Medicare reimbursement for non-emergency medical transportation. Because we want to ensure you are no longer confused by the various sources of online disinformation, we would like to make the issue of Medicare reimbursement abundantly clear.
As of this posting, Medicare will not reimburse for non-emergency transportation unless it is provided by an Advanced Life Support (ALS) ambulance or a Basic Life Support (BLS) ambulance. Obviously, this stipulation leaves out the vast majority of traditional NEMT providers (ambulettes) focused solely on providing non-emergency medical transportation.
So the questions begs, how is this possible? How it is that Medicare is willing to pay 5-10 times as much for an ALS or BLS vehicle with multiple EMTs to render non-emergency transportation versus a traditional ambulette service? Obviously, common sense suggests it is far more economical to use a traditional ambulette service versus and ambulance service. After all, it is non-emergency transportation.
It would be easy for us to attempt to explain Medicare's justification for this shameful and wasteful spending being due to the potential risk of providers needing to offer the patient more advanced services. However, again, because this is for non-emergency transportation services, the likelihood of such circumstances developing is exponentially miniscule and cannot be justified.
Therefore, truth be told, the foundational reason why Medicare will reimburse ALS/BLS services for non-emergency medical transportation but not reimburse ambulette services and save untold volumes of money is, quite simply, because the ambulance lobbying machine is simply too strong and too entrenched.
When we share such information it never fails to be enlightening and poignant. Very few people and providers realize just how vast, powerful and entrenched the ambulance lobbying mechanism is and their ability to influence private and government forms of subsidized insurance and reimbursements. By gaining a monopoly on Medicare's reimbursement for non-emergency medical transportation and barring traditional ambulette providers from gaining access to such reimbursement, the ambulance industry is able to maintain a very strong and lucrative negotiating position with hospitals and medical centers in addition to lining the pockets of politicians.
If you're considering starting an NEMT business and are researching information online, you need to avoid and reject any resource(s) that suggests Medicare funding is growing for NEMT providers. It is not. Such reimbursement is only growing for ambulance providers offering NEMT services in addition to their standard emergency services. Anyone making such claims is simply an online salesman and not an industry experienced provider.