How facilities should choose a medical transportation company: the questions to ask

Start with the rides your patients need

Write down what your patients or residents need before you call anyone. A company that runs good ambulatory rides may not own a stretcher van, and one with plenty of wheelchair vans may not answer the phone at 5 AM.

Cover four things:

• Levels of service. Ambulatory riders walk, with or without a cane or walker. Wheelchair riders stay seated in their own chair. Stretcher riders travel lying down. See level of service for the full list.
• How much help at each end. Virginia’s Medicaid program uses three levels. Curb-to-curb means help at the vehicle only. Door-to-door adds an escort between the vehicle and the front door at each end. Hand-to-hand means the driver passes the rider to a staff member or family member at the destination. The first two levels leave out lifting the rider.
• Hours and timing. Early dialysis chairs, evening discharges, and weekend returns can rule out smaller companies.
• Who pays. Rides your facility pays for can go to any company you choose. Rides paid by Medicaid usually have to be booked through the state’s broker or the patient’s health plan, and the company must be in that network. Our guide to booking a Medicaid ride for a patient covers that path.

Nursing homes have a standing need. Federal rules require skilled nursing and nursing facilities to help residents arrange transportation to dental appointments when necessary or requested (42 CFR 483.55), and to lab and radiology services when a resident needs help (42 CFR 483.50).

Confirm the company is enrolled and in good standing

A few public lookups take ten minutes and screen out the riskiest companies.

1. Look up its NPI. A company that bills Medicaid or health plans for rides will usually have a National Provider Identifier. The free NPI Registry shows its legal name, address, and provider type. Van companies commonly carry taxonomy 343900000X, Non-emergency Medical Transport (VAN).
2. Search the exclusion list. Search the OIG List of Excluded Individuals/Entities for the company name and each owner. Excluded parties cannot be paid by Medicare, Medicaid, or other federal health programs for their services, and the OIG warns that hiring someone on the list can bring civil monetary penalties. See our exclusion list glossary entry.
3. Ask which brokers and plans it serves. If it says it runs Medicaid trips, ask which broker or health plan networks it is credentialed with. Credentialing means someone else has already reviewed its drivers, vehicles, and insurance.
4. Ask for its permits. Rules for carrying passengers for pay vary by state and city. Ask which permits it holds and see copies. For trips across state lines, Virginia’s broker handbook requires federal interstate operating authority when the law calls for it.

Ask for proof of insurance

Ask for a certificate of insurance sent directly by the company’s insurance agent, not a copy the company made. It should show auto liability with the limit, general liability, workers’ compensation, and the policy dates. Our certificate of insurance entry explains how to read one.

Minimum limits depend on where the rides go:

State minimums are floors. Your facility’s contract can require higher limits. Ask your risk manager what to require and whether your facility should be named on the policy. If drivers ever use their own cars, ask about hired and non-owned auto coverage. Ask for a fresh certificate at every renewal.

Look closely at drivers

Ask to see documents, not assurances. MTM Health’s provider handbook for Virginia Medicaid is a useful yardstick because it spells out its driver minimums (the state’s own floor sets the age at 18; MTM asks for 21):

Then ask the company six questions:

1. Can we see a sample driver file with personal details removed?
2. How often do you re-run driving records and exclusion checks?
3. Do drivers pass a drug screen before hire?
4. Who trains drivers, and where is each course recorded?
5. Do regular riders get the same driver?
6. Does every ride run on your own vans with your own drivers, or do some go to another company?

Nursing homes have an extra reason to ask. Federal rules bar a nursing home from employing or otherwise engaging anyone found guilty of abuse, neglect, exploitation, or mistreatment by a court, or with such a finding on the state nurse aide registry (42 CFR 483.12(a)(3)). Ask your administrator how that applies to outside drivers, and put the company’s screening promise in the agreement. Our guides to driver background checks and driver training show what a good file holds.

Inspect a wheelchair van

Ask to see a van and watch a driver secure an empty wheelchair. The federal ADA vehicle specifications set the baseline, and Virginia’s broker handbook requires every vehicle in its program to meet them (49 CFR 38.23):

• On vehicles rated up to 30,000 pounds gross weight, a securement system designed to restrain a forward force of up to 2,500 pounds per strap or clamp and at least 5,000 pounds per wheelchair.
• Movement of an occupied wheelchair limited to 2 inches in any direction.
• A lap belt and shoulder harness for the rider at every wheelchair position, which may not replace the straps that hold the chair.
• A lift with a design load of at least 600 pounds.

Virginia’s Medicaid program adds four working securements per wheelchair station, a working interlock system, and a lap and shoulder belt made for wheelchair riders. Its wheelchair and stretcher vans are inspected before use and twice a year. MTM Health’s Virginia handbook also expects air conditioning that cools the cabin to about 68°F and heat to about 74°F, measured from the rear.

On the visit, look for frayed straps, belts lying on the floor, a stocked first aid kit, and a fire extinguisher within the driver’s reach. Our wheelchair securement standards guide explains each part.

Ask for on-time numbers and how they are measured

Ask for three months of on-time results, split into pickups and appointment arrivals. Then ask how the times were recorded. Times stamped by GPS when the van arrives are harder to shade than times a driver types in later.

Compare the numbers with the standard your area’s Medicaid program uses. Virginia is a useful example. MTM Health arranges Virginia’s fee-for-service Medicaid trips for dates starting October 1, 2026, and its handbook for that program sets these standards:

Ask how the company handles a late van: who calls your staff, and how early. Ask what happens when a van breaks down or a driver calls in sick, and how many spare vehicles and drivers it keeps. Our on-time performance guide explains the formulas behind these numbers.

Find out how complaints and incidents reach you

A company that keeps a complaint log will show it to you with names removed. Look at how many complaints it gets, what they are about, and how fast each one was closed. MTM Health’s Virginia handbook caps substantiated complaints below 0.1 percent of completed trips (under 1 per 1,000) and missed trips below 0.25 percent of assigned trips.

Settle incident reporting before the first ride:

• Who calls you, and how fast. A fall, a wheelchair tip, or a vehicle accident should reach your staff by phone at once, then in writing the same day.
• Nursing home deadlines. A nursing home must report alleged abuse, neglect, or injuries of unknown source to its administrator and state officials within 2 hours when abuse or serious bodily injury is involved, and within 24 hours otherwise. Your agreement should require the company to tell you immediately.
• Emergencies. Transportation drivers are not paramedics. Ask what drivers are trained to do when a rider becomes ill; our guide to medical emergencies during a ride covers the usual protocol.

Our incident report template shows the fields a good report carries.

Settle privacy terms early

Your staff will share names, addresses, appointment times, and mobility needs. The HIPAA Privacy Rule lets a covered entity disclose protected health information for another provider’s treatment activities (45 CFR 164.506). Whether you also need a business associate agreement depends on the arrangement, since the definition of a business associate leaves out a health care provider that receives information for a patient’s treatment (45 CFR 160.103). Your privacy officer makes that call.

Ask the company four things:

1. Will you sign our business associate agreement if we require one?
2. How do trip details reach drivers, and are personal text messages ever used?
3. Do drivers complete HIPAA training, and when?
4. How and how quickly will you tell us about a privacy breach?

See our HIPAA guide for transportation providers for what good practice looks like on their side.

Compare price and billing terms, not just the base rate

Two companies with the same base rate can cost very different amounts once waiting, no-shows, and after-hours trips are added. Ask for a written rate sheet with:

• A base rate per one-way trip and a per-mile rate for each level of service.
• Wait time charges and the free window before they start.
• No-show and late cancellation fees.
• After-hours, weekend, and attendant charges.
• Invoice timing, what each invoice shows (date, times, and miles for every trip), and payment terms.

Keep the relationship clean. Knowingly paying for referrals of Medicare or Medicaid rides is a federal crime under the Anti-Kickback Statute, and the OIG counts meals and hotel stays as remuneration. A company that offers your staff gifts or referral payments is showing you how it does business. Our anti-kickback guide explains the rules, and our facility transportation agreement template lists the terms to put in writing.

A sample scorecard

Score every company on the same sheet after you have its documents, two or three references from facilities like yours, and a trial month of trips. The weights below are an example; set your own.

Rate each area from 1 to 5, multiply by its weight, and divide the total by 5. A company scoring 90 or more out of 100 is a strong pick in this example. Give the finalist your hardest trips during the trial, such as early chair times and weekend discharges, and score it again every quarter.

What to ask about the company’s software

Ask each company how you will request rides, track them, and check its numbers. Transportation companies that run on HealthRide can give your staff a facility portal to request rides, follow vehicles live, and view and pay invoices. Their trip logs show scheduled and actual times and GPS-verified miles for every ride, so the on-time results on your scorecard are easy to check. See reports.