Examples of such trips are doctor appointments deemed urgent by the physician, and hospital discharges.
Emergency trips are not arranged through LogistiCare. If an emergency trip is needed, 911 should be called.
Sudden life threatening medical situations, significant trauma, comas, shock, uncontrolled bleeding, respiratory distress, poisoning, drug overdose and any situation where immediate medical relief or treatment is necessary.
Non-emergency medical transportation by Stretcher Van or BLS/ALS ambulance falls into two categories based on whether life support services are required during transport:
1. Non-emergency medical transportation without life support services (for a member who requires transportation in a supine position). This category
of transportation is provided by SMV Stretcher Van or in an ambulance (optional). NEMT without medical care during transport require:
a. The NEMT provider is required to be contracted with LogistiCare.
b. The transportation will not require a prescription for medical need.
c. The referring hospital, clinic, or other originating facility will be required to coordinate the transportation through LogistiCare.
2. Non-emergency medical transportation requiring medical care during transport either by BLS or ALS are always provided by ambulance. The follow
procedure is required:
a. The ambulance provider will be required to be contracted with LogistiCare.
b. The transportation must be prescribed by a physician, physician assistant, or nurse practitioner. The prescription must:
i. Be in writing.
ii. Be maintained and stored in the patient's record at the referring hospital, clinic, or other originating facility.
iii. State what medical care is necessitated by the member's condition that requires transport with life support services.
c. The referring hospital, clinic, or other originating facility will have two options for coordinating transportation:
i. Coordinating through LogistiCare. With this option, the referring hospital, clinic, or originating facility will contact LogistiCare directly to
arrange the transport. The hospital, clinic, or facility will be required to fax a copy of the prescription to LogistiCare.
ii. Coordinating directly with the ambulance provider. With this option, the ambulance provider is required to contact LogistiCare within
24 hours after dispatching the trip to obtain a prior approval trip identification number (trip ID). The ambulance provider is
required to obtain the prescription for medical need and submit to LogistiCare.
Trips for member to travel out of state require prior authorization of DHS’ Division of Health Care Access & Accountability. After the Prior Approval has been granted services are booked with LogistiCare using the same process that other trips are booked as long as they are to a Medicaid reimbursable service. Trips to “border states” do not require prior authorization of DHS’ Division of Health Care Access & Accountability. Trips to non-border states do.
The level of service describes the type of transportation service needed to transport the member. A member can travel by one of several levels of service based on their medical needs and mobility.
1. Bus Pass/Mass Transit
a. The member lives within ¼ mile of a bus stop
b. The medical facility is within ¼ mile of a bus stop
c. The member can walk ¼ mile
d. The member understands common signs and directions
e. Bus passes can be obtained by calling LGTC
a. The member can walk unassisted from doorway of residence to the curb
b. The member can walk unassisted from the vehicle to the medical facility
3. Wheelchair can transfer
a. The member can transfer from the wheelchair to the seat of an ambulatory vehicle
b. The member’s wheelchair folds and can be placed in the rear of the vehicle
The member is permanently confined to wheelchair
a. The member cannot transfer from the wheelchair to the seat of an ambulatory vehicle
b. The member requires a lift-equipped wheelchair van
a. The member is confined to bed
b. The member cannot sit up or sit in a wheelchair
c. Non-emergency BLS or ALS transport may be requested if the member requires medical monitoring/services during transport
Yes. The hospital or originating facility must provide an order of prescription from a physician, physician assistant, or nurse practitioner verifying medical necessity for the transport.
Wisconsin standards require that if a request for NEMT falls under one or more of the denial criteria listed below, then LogistiCare must deny the request:
If the referring Facility has a problem or concern with service, call LogistiCare at 1-866-907-1494 or write to LogistiCare at the following address with your complaints:
LogistiCare Solutions, LLC
2335 City View Drive
Madison WI 53718
LogistiCare will get back to you with an initial response in 10 business days. A final response will be sent to you in writing within 30 business days of receiving a complaint.