Becoming an approved hospital transportation vendor: credentialing, contracts, and case managers
An approved hospital transportation vendor is a company the hospital has onboarded through purchasing and credentialing and put under a written contract, so staff can book it and accounts payable can pay it. Getting there takes a supplier packet (tax form, insurance certificates, exclusion checks, staff screening), a privacy agreement where required, a signed contract with rates and response times, and invoices that match the hospital's purchase order rules.
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What “approved vendor” means at a hospital
An approved vendor is a company the hospital has set up to buy from: it is registered in the purchasing system, credentialed to enter patient areas, under a signed contract, and able to receive purchase orders and payments. Case managers can like your service, but until those pieces are in place they often cannot book you and accounts payable cannot pay you.
Federal hospital rules explain why the process is formal. Under 42 CFR 482.12(e), the hospital’s governing body is responsible for services furnished in the hospital whether or not they come from contractors. It must ensure contracted services are provided in a safe and effective manner, and the hospital must keep a list of all contracted services with their scope and nature. A transportation company that comes onto the units to pick up patients is one more contractor the hospital has to answer for.
This guide covers getting approved. For running the rides themselves, see our guide to hospital discharge transportation.
Who picks the vendor
Several departments have a say, and each needs something different from you.
| Department | What it does | What it wants from you |
|---|---|---|
| Case management and discharge planning | Books rides and feels every late pickup | Fast answers, real pickup times, drivers who find the unit |
| Purchasing or supply chain | Registers suppliers, issues purchase orders, holds contracts | A complete supplier packet and pricing in its format |
| Compliance and privacy | Reviews exclusion checks and privacy agreements | Clean screening results and a signed agreement |
| Risk or insurance | Sets insurance requirements | Certificates that match its limits and wording |
| Accounts payable | Pays invoices | Invoices that match the purchase order |
Case managers are where demand starts, so meet them first. Purchasing is where the relationship becomes a contract.
The patient’s payer also matters. The federal discharge planning rule requires hospitals to give patients a list of available home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals when those services are indicated (42 CFR 482.43(d)). Transportation companies are not on that list. When Medicaid pays, the state’s rules decide who arranges the ride, often a broker or health plan. In Indiana’s fee-for-service program, for example, hospitals call the broker’s facility dispatch line for discharges home, and the state’s provider manual says the broker will respect current preferred-provider relationships. Being the hospital’s preferred vendor and being in the broker’s network work together.
Since July 1, 2025, 42 CFR 482.43(c) has also required hospitals to keep written procedures for moving patients to the level of care they need, another hospital included, and to train the staff involved every year. Ask whether the hospital’s transfer policy names transportation vendors and how you get listed.
The credentialing packet
Expect a supplier packet before your first paid ride. Requirements vary by hospital, so ask for the full list up front. The table shows what commonly comes up and why.
| Item | Why the hospital asks |
|---|---|
| Form W-9 | The IRS form gives your taxpayer ID to anyone who must file an information return about payments to you |
| Certificates of insurance | Proof you carry the limits its risk office sets, with the hospital named as additional insured when required |
| Exclusion screening | OIG says excluded parties can receive no federal health care program payment for items or services they furnish, and hiring someone on the exclusion list can bring civil penalties |
| Staff background checks | Drivers enter patient areas and handle patient information |
| Immunizations and TB screening | Infection prevention rules for anyone working on site |
| Credentialing badge | Some systems use a third-party service to badge vendors before they enter clinical areas |
| Privacy agreement | A business associate or confidentiality agreement covering patient information |
| Company documents | Business license, state transportation permits, Medicaid enrollment if you carry Medicaid patients |
One large system shows how specific these rules get. Mass General Brigham’s supplier requirements include:
- Badging. At most of its facilities, vendor representatives who need access to patient care areas must register with its credentialing service and get a badge first.
- Background checks. Required for supplier employees who will access patient information or work on site for more than three weeks. People on site for less time must be accompanied by a hospital employee. A result other than “no record” on a criminal, sex offender, exclusion, or state check needs written approval before that person works for the system.
- Flu vaccination. Required for anyone working on site for one day or more during flu season, September 15 to April 30.
- TB and measles, mumps, and rubella. Clinical documentation is required for people on site more than three weeks, or 120 cumulative hours in a year.
Check the OIG exclusion list yourself for every new hire and for your company, and keep the results. Expect the hospital to run the same search.
Insurance: ask for the exhibit before you quote
Hospital insurance requirements can be far higher than your state’s minimums, and higher limits change your premium. Get the insurance exhibit early.
Mass General Brigham’s 2026 insurance terms for suppliers are an example of what a large system can ask for:
| Coverage | Requirement |
|---|---|
| Commercial auto liability | $1 million combined single limit per accident, or $20 million per accident for a supplier transporting people |
| Commercial general liability | $1 million per occurrence and $3 million aggregate |
| Information security and privacy breach | $5 million per event and in aggregate, if the supplier has access to patient information |
| Workers’ compensation | As state law requires, plus employer’s liability of at least $1 million |
| Additional insured | The system and its related entities, primary and non-contributory, with a waiver of subrogation |
The same document lets suppliers reach those limits by combining primary policies with excess or umbrella policies. If your auto policy carries a lower limit, talk to your agent about umbrella or excess coverage before you bid, and build the premium into your rates. See our glossary entry on certificates of insurance for how proof of coverage is issued.
HIPAA agreements
Hospitals may ask transportation vendors to sign a business associate agreement (BAA) or a confidentiality agreement before they share patient names, units, and destinations. Read it before you sign, because it sets real duties.
Under 45 CFR 160.103, a business associate is someone outside the hospital’s workforce who handles protected health information for the hospital: creating, receiving, keeping, or sending it on the hospital’s behalf. A health care provider that receives patient information from a covered entity for that patient’s treatment is excluded from the term. Whether your company is a business associate of a given hospital depends on what you do for it, and the agreement will state the role the hospital has chosen.
If you sign a BAA, plan to meet it:
- Protect patient information on phones, manifests, and email, under the HIPAA Security Rule.
- Report a breach of unsecured patient information to the hospital without unreasonable delay and no later than 60 calendar days after you discover it (45 CFR 164.410).
- Pass the same duties to any subcontractor that handles the hospital’s patient information.
Our guide to HIPAA for NEMT covers risk analysis, training, and safeguards.
What the contract should say
A hospital contract should settle these points before the first ride:
| Term | What to settle |
|---|---|
| Services | Levels of service (ambulatory, wheelchair, stretcher), service area, hours, and days |
| Response times | Scheduled trips, same-day discharges, and after-hours requests, each with a number |
| Pickup inside the hospital | Where the driver reports, who hands off the patient, and who handles transfers |
| Who pays for which rides | Rides the hospital pays for under its own policy, and rides billed to Medicaid, a plan, or the patient |
| Rates | Base and mileage by level of service, wait time, no-shows, cancellations, after-hours charges |
| Invoicing | Purchase order rules, invoice contents, payment terms |
| Insurance and indemnity | Limits, additional insured, certificates on request |
| Privacy | The BAA or confidentiality agreement, and what patient details may appear on invoices |
| Reporting | On-time pickups, completed rides, incidents |
| Term | Start date, renewal, and termination notice for both sides |
When the hospital pays for a patient’s ride, its program has to fit federal anti-kickback rules. The safe harbor for local rides in 42 CFR 1001.952(bb) comes with conditions, among them a written policy the hospital applies uniformly, no advertising of the free rides, and no per-patient pay for drivers. Distance caps are lifted for a patient returning home after an admission or a stay of 24 hours or more in observation. Fitting its program to those rules is the hospital’s job. Do not pay hospital staff for referrals in any form.
The hospital discharge ride checklist covers the details a booking call should capture.
Discharge and outpatient work are different contracts
Hospital rides fall into a few types, and each has its own rhythm.
- Inpatient discharges. Same-day, hard to schedule to the minute, and often wheelchair or stretcher. This is where response time wins or loses the account.
- Outpatient appointments. Cancer treatment, therapy, and specialty clinics book ahead, often on repeating schedules. These fill a vehicle’s day predictably.
- Transfers between campuses or facilities. Some can go by wheelchair or stretcher van. A patient who needs medical care during the ride needs an ambulance.
Government hospitals buy in public. In 2026, the Dallas VA Medical Center took proposals on SAM.gov for non-emergency wheelchair transportation on an as-needed, 24-hours-a-day basis under solicitation 36C25726R0014: a 54-month ordering period, set aside for service-disabled veteran-owned small businesses, with privacy, HIPAA, information security, and records language added to its work statement. Our VA contracts guide explains how those solicitations work.
Invoicing a hospital
Hospital accounts payable follows purchase order rules strictly. An invoice that does not match gets returned, and the payment clock restarts.
Mass General Brigham’s supplier rules show what to expect:
- One purchase order per invoice. Its purchase order numbers follow a fixed format, and only one may appear on each invoice. If you do not have one, get it from the department you work with.
- Statements do not trigger payment. Statements must list purchase order numbers, invoice numbers, and balances, and the system does not pay from statements.
- Net 45. Standard terms are 45 days from the invoice date, and invoices may not include interest or late fees.
Put each one-way ride on its own line with the date, pickup and destination, level of service, and charges. Limit patient details to what the hospital needs to match the ride, such as its own reference number. Our facility billing guide covers monthly statements and disputes.
Serving hospitals in HealthRide
Hospital staff can request rides in their own HealthRide portal and see the vehicle coming on a live map, which cuts down on status calls to your dispatch. Same-day discharges are assigned to a driver in one motion on the dispatch board, and completed rides roll into the hospital’s invoice with a pay-online link. HealthRide is HIPAA compliant, and each person on your team sees only what their role allows.
Frequently asked questions
- Who decides which transportation company a hospital uses?
- Several departments have a say. Case managers and discharge planners book the rides and push for the vendors that show up. Purchasing or supply chain onboards the vendor and holds the contract, compliance and privacy review the paperwork, and accounts payable pays. Win the case managers first, then work through purchasing.
- Do hospitals have to offer patients a choice of transportation company?
- Not under the federal discharge planning rule. Its choice list covers home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals for patients referred to those services, and transportation companies are not on it. The patient's payer can still decide: a Medicaid broker or health plan arranges the rides it pays for.
- Will a hospital ask my transportation company for a business associate agreement?
- It may, or it may ask for a confidentiality agreement instead. Under HIPAA, a business associate is an outside company that handles patient information while doing work on behalf of a hospital or other covered entity. The definition does not cover a health care provider given information to treat the patient. Your role depends on what you do for the hospital, so read its agreement closely and meet every duty it assigns you.
- What insurance does a hospital require from a transportation vendor?
- Whatever its risk office sets, and it can be far above state minimums. Mass General Brigham's 2026 supplier insurance terms ask for $1 million in commercial auto liability from suppliers that drive but $20 million per accident from companies transporting people, which can be met with umbrella or excess policies. Ask for the insurance exhibit before you quote.
- How long does a hospital take to pay?
- As long as its terms say. Mass General Brigham's standard terms are net 45 days from the invoice date, invoices may not add interest or late fees, and it does not pay from statements. Build the wait into your cash plan and follow the purchase order rules exactly so invoices are not sent back.
- Is it legal for the hospital to cover the cost of a patient's trip?
- Yes, when the program meets federal rules. A safe harbor under the anti-kickback law covers free or reduced-cost local rides offered under a policy applied to all patients alike, and its 25-mile and 75-mile caps are lifted for patients discharged home from an inpatient admission, or released home after 24 hours or more under observation. The hospital is responsible for its own program. Your part is the contract and accurate invoices.
