How to get private pay NEMT clients: the referral sources families already trust

Most private-pay NEMT clients do not find you by accident. A daughter arranging rides for her father, for example, may ask a care manager, a lawyer, the senior center, the staff where he lives or the hospital case manager before she ever searches online. Getting private-pay work means becoming the name those people give, and then keeping the client after the first ride.

This page covers where those referrals come from and how to earn them. Pricing and collecting are in our guide to private pay NEMT, and search, reviews and your map listing are in the NEMT marketing guide.

Who families ask before they call a ride company

Six kinds of referral sources are worth working, and each one is reached a different way.

Hospital, waiver and health plan case managers each work under their own rules, covered in our guide to case manager referrals. Getting onto aging center lists and free directories is in where to list a NEMT business. What follows is the private-pay side.

Aging Life Care managers: the professionals families hire to run care

Aging Life Care managers are the professionals families hire to run an older relative’s care. Part of that job is finding and engaging local services for the client, and a ride company is one of them. The Aging Life Care Association describes members who come from nursing, social work, gerontology and similar fields. They go to doctor appointments with clients, review or oversee bill paying, and act as the emergency contact for relatives who live out of town.

To reach them:

1. Search the association’s directory. ALCA’s “Find an Aging Life Care Expert” search lists members near you. Call each one, say what service levels you run, and ask how they book rides today.
2. Look at the Corporate Partner program. ALCA’s Corporate Partners are industry supporters outside care management. Its list of examples includes elder law attorneys, home health agencies, nursing homes, assisted living, equipment suppliers and other services related to the care of elders. ALCA keeps a “Find a Corporate Partner” directory as well. Free senior placement agencies are not eligible.
3. Make their job easier. Care managers want a ride that shows up, a driver who walks the client to the door, and a short message when the client is home. If they attend appointments themselves, offer to pick them up with the client. If a client needs someone to stay through the visit, our guide to medical escorts for seniors explains how escort service differs from a ride.

Expect to compete on service. ALCA’s Standards of Practice (revised May 2026) say referrals must rest solely on the client’s best interests. When a care manager has a business or personal tie to a recommended provider, the standards say the member should explain the tie to the client and offer other choices.

Elder law attorneys and the people who hold the checkbook

Elder law attorneys work with families on guardianship, trusts and paying for long-term care, so they meet the people who end up paying for rides. The National Academy of Elder Law Attorneys, founded in 1987, offers a public “Find a Lawyer” search by ZIP code and distance, and the topics on its site include guardianship, government benefits and veterans issues.

Visit the firms near you and leave a short handout listing your service levels, area and booking number. The goal is to be the name the firm gives a family that asks about rides.

The payer is often not the rider. An agent under a power of attorney, a court-appointed guardian or a trustee may pay the bill. State law sets what an agent may spend on. In North Carolina, for example, an agent with general authority over personal and family maintenance may cover necessary health care and custodial care costs and continue the principal’s transportation arrangements (G.S. 32C-2-213). On the first call, ask who will pay and in what role, put both names on the invoice, and send receipts the payer can keep for their records.

Senior centers, aging agencies and senior living staff

Community organizations can only refer you once their staff know your name. Three are worth regular visits:

• Aging and disability resource centers. These centers answer questions about public and private help for people at any income, so families who will pay privately call them too. Getting onto their resource lists is covered in where to list a NEMT business.
• Senior centers. Under the Older Americans Act, senior centers are community hubs that bring health, meal, education and social programs to people 60 and up. Offer the center a short session on getting to appointments, covering wheelchair rides, escorts and what Medicare does and does not pay for, and leave a printed rate sheet.
• Senior living staff. Find out which staff member residents ask about rides, often resident services or the wellness director, and make sure your number is the one they hand out. See senior living transportation partnerships for what these communities expect.

What you can and cannot give a referral source

Give referral sources reliable rides and fast answers, and nothing else of value tied to referrals. Three sets of rules point the same way.

• Federal law. The Anti-Kickback Statute, 42 U.S.C. 1320a-7b(b), treats it as a felony when someone pays, or offers to pay, anything of value, cash or otherwise, in exchange for a referral of care that Medicare, Medicaid or another federal program may pay for, even in part, and does so knowingly and willfully. A private-pay client may also have Medicare or Medicaid for other care, and the same referral source can send you both kinds of riders. Our Anti-Kickback Statute guide covers the safe harbors and the cases.
• The referral source’s own code. ALCA’s Standard 24 bars members from accepting or giving referral fees, fee splitting, kickbacks or similar arrangements. The guidance says the ban covers indirect benefits such as large gifts, discounts or favors, while small gifts of appreciation are acceptable.
• State patient brokering laws. Some states reach further than the federal law because they apply whoever pays. Florida’s statute (817.505) makes it unlawful for anyone to pay a commission, bonus, rebate, kickback or bribe for steering patients toward or away from a provider or facility, whether in cash or in kind. Even one violation is a third-degree felony carrying a $50,000 fine; the fine climbs to $100,000 when the scheme involves 10 to 19 patients and to $500,000 at 20 patients or more. Florida’s definition of a provider covers anyone licensed, certified or registered with the Agency for Health Care Administration or the Department of Health, and anyone under contract with that agency to serve Medicaid recipients. Other states define it differently, so have a lawyer read your state’s version before you offer any referral reward.

Rewards for riders need the same care: if you run a referral credit for private-pay riders, keep anyone covered by Medicare or Medicaid out of it, and see what you can give riders for OIG’s gift limits.

Turning the first ride into a standing schedule

A private-pay client is worth far more as a schedule than as a single ride. As an example, a rider going to physical therapy twice a week for six weeks needs 24 one-way trips. These steps turn the first call into that series:

1. Ask the coverage question first. Some callers are on Medicaid, and some carry Medicare Advantage coverage with rides included, either of which may pay for the trip. Tell them so before you take their money. See private callers who have Medicaid and Medicare Advantage rides.
2. Quote the whole series in writing. Give the per-trip price, wait time charges and the cancellation rule before the first pickup. Our guide to all-in pricing laws covers what a quote must include.
3. Set up payment once. Save the card with the payer’s written consent so repeat rides need no phone call. See charging private-pay riders by card.
4. Keep the same driver and pickup time. Assign the same driver at the same hour whenever you can, so the rider knows who is coming.
5. Report back, with permission. Ask the rider or family in writing whether you may send ride updates to their care manager. A two-line message after each trip shows the referral source that the ride went well.
6. Offer the next step. At the end of a series, ask about upcoming appointments. Some families prefer a prepaid bundle; our guide to ride packages covers how to price one.

Keeping private-pay clients with HealthRide

Riders and families book online in HealthRide and follow their driver live from a text link. For repeat rides, schedule it once and HealthRide keeps it going. Riders and families can pay by card, with pay links and saved cards. See recurring trips and payments.