What a broker provider manual really says: the trip rules, deadlines, and pay terms to find first
Your broker's provider manual holds the day-to-day rules behind the contract: pickup windows, how long to wait for a rider before recording a no-show, signature and trip log rules, incident reporting deadlines, turnback cutoffs, and claim deadlines. Rates and penalty amounts usually sit in the agreement itself. Read both, keep the dated version you work under, and turn the key rules into a one-page summary for drivers and dispatch.
On this page
Where the manual sits among your broker’s rules
A provider manual (some brokers call it a handbook) is the operating rulebook for one broker program. It sits in a stack of documents, and knowing which layer holds which rule saves hours when a question comes up.
| Layer | What it usually holds | Example |
|---|---|---|
| State Medicaid policy | Program-wide rules every provider follows | New York’s Medicaid Transportation Policy Manual, which the MAS manual supplements |
| Broker agreement | Term, rates, penalty amounts, insurance, credentials, termination | MTM Health’s agreement attaches its rate sheet as Schedule A, performance standards as Schedule B, and credentials as Appendix B |
| Provider manual or handbook | Day-to-day trip, reporting, billing, and portal rules | MTM Health’s Virginia handbook covers pickup windows, trip manifests, claims, and training |
| Letters and bulletins | Changes between editions, each with an effective date | MAS’s September 11, 2025 letter on real-time GPS |
The layers point at each other. WellTrans’s Indiana agreement makes its Indiana Transportation Provider Manual part of the contract by reference, so breaking the manual breaks the contract. MTM Health’s Virginia handbook works the other way for money: for dollar amounts on liquidated damages it defers to the provider’s service agreement, and for the full credential list, to that agreement’s Appendix B. Read the manual and the agreement together, never one without the other.
Get the right version
The manual you follow has to match your program and date.
- One broker, several manuals. Brokers that run programs in several states usually publish one handbook per program. In Virginia, MTM Health accepts a clean claim for six months from the ride date; in Rhode Island, the same broker’s cutoff is 90 days. A dispatcher who learned the rules in one state can miss a deadline in the other.
- Check the cover dates. MTM Health’s Virginia handbook shows an approval date (August 10, 2026) and a last-updated date (July 30, 2026). The Rhode Island edition shows its original approval (May 15, 2023) and its last update (July 1, 2026).
- Know where the current copy lives. WellTrans’s agreement commits it to keeping the most current manual on its website. MTM’s agreement says changes to credentialing requirements are posted online.
- Keep every edition you worked under. File a dated copy each time the manual changes. When a broker disputes a trip from last spring, the rule that applied then is the one that matters.
The trip rules to pull first
Start with the rules a driver applies on every ride. These examples come from current handbooks; your program’s numbers may differ.
| Rule | What to look for | Examples from published manuals |
|---|---|---|
| Pickup window | How early and late a driver can arrive and still count as on time | MTM Virginia: on time means arriving in the 15 minutes before or the 15 minutes after the scheduled pickup; the window covers only the first leg |
| Early arrival | Whether riders must board early | MTM Virginia and Rhode Island: an early van is fine, but riders never have to get in before the scheduled time |
| Wait before a no-show | Minutes to wait and who to contact first | MTM Rhode Island: a driver may leave once 10 minutes have passed after the scheduled time, after a call or text letting the rider know the van is there or about to go. MTM Virginia: a rider still not ready at the end of the window is handled under MTM’s no-show procedure, once the driver has tried a call or text |
| Drop-off | The latest acceptable arrival | MTM Virginia: by the scheduled appointment time |
| Will-call returns | Response time after the rider calls | MTM in both states: 45 minutes. WellTrans Indiana: 60 minutes, with a charge for missing it |
| Hospital discharges | Response time after notice | MTM Virginia: within 3 hours |
| Shared rides | Longest extra ride time | MTM Virginia and Rhode Island: no more than 45 extra minutes compared with riding direct |
| Address changes | Who can approve a different stop | MTM Rhode Island: only manifest addresses; MTM must approve and update the manifest first |
| Signatures | Who signs and how | WellTrans: the rider signs; if unable, a relative in the household, a caretaker, or staff at the drop-off facility signs their own name and relationship. Initials or “unable to sign” notes are rejected, and drivers may never sign the rider’s name |
| Tracking | GPS during the ride | MTM Virginia: location tracking running from pickup through drop-off on every ride |
The deadlines the office owns
The second group of rules runs through dispatch and billing. Missing one of these usually costs money directly.
| Deadline | Examples from published manuals and agreements |
|---|---|
| Turnbacks | MTM Virginia: 24 hours or more ahead of the scheduled pickup. MTM Rhode Island: no returns at all for same-day trips or for trips you took from the marketplace, and other trips need a full day’s notice before the appointment. WellTrans: 12 hours’ notice before pickup, for any trip it sent you 36+ hours in advance |
| Incident reporting | MTM Rhode Island: serious incidents by phone at once, written report due within 24 hours, police report (if any) due within 5 business days. WellTrans: a call within 3 hours for injuries or moving violations, and a written report inside 24 hours. CareOregon: immediate written notice if anyone is injured or dies, or a driver faces an abuse allegation, and 24 hours for accidents and incidents without injury |
| Credential renewals | MTM Rhode Island: new documents in 10 business days ahead of expiration |
| Claim submission | MTM Virginia: 6 months. MTM Rhode Island: 90 days. WellTrans: 60 days, with invoices after 90 days refused |
| Claim appeals | MTM Virginia: 365 calendar days from denial |
| Record retention | MTM and WellTrans agreements: 10 years. CareOregon: at least 6 years |
The pay terms to find
The manual and agreement together decide what each trip pays. Five terms deserve a careful read before you run the first ride.
- The rate sheet. Find the schedule that sets base rates, mileage, and extras. MTM Health calls it Schedule A; WellTrans attaches its rates to Exhibit B.
- How mileage is measured. WellTrans measures each trip with mapping software, takes the shortest route between the two addresses, and rounds it to a whole number of miles. If you think a distance is wrong, raise it before running the trip, because running it means accepting the broker’s mileage.
- What makes a claim clean. MTM Health’s handbooks deny a claim unless the electronic trip log has the rider’s signature, the trip ID, and four times (the scheduled and actual pickup, the departure, and the arrival), and the trip still shows as completed.
- What gets paid extra and what does not. WellTrans pays wait time only with its advance approval, which it generally grants only on trips beyond 50 miles. It pays trips it classes as shared at the shared rate, whether or not the riders traveled in one vehicle.
- When the money arrives. MTM’s agreement pays uncontested invoices inside 30 days after they are submitted online. WellTrans pays on a twice-monthly cycle, inside 30 days of each submission, and pays only for trips where the rider actually attended a covered appointment.
Our guide to billing brokers goes deeper on submitting and reconciling claims.
Performance standards and what missing them costs
Most manuals publish a scorecard. In Virginia, MTM Health’s field monitors review nine measures with each provider, among them timeliness (target: better than 95%), provider no-shows (target: below 0.25%), and claim denials (target: below 0.29%). The Rhode Island handbook grades similar measures green, yellow, or red.
The consequences for missing them are spread between the manual and the agreement: improvement plans, liquidated damages, fewer trips, and termination. Our guide to broker penalties lays out the published amounts.
How changes reach you
Manuals change more often than contracts, and the broker decides when. Each broker has its own way of telling you.
- WellTrans sends updated manual versions, and providers then have 5 business days from receipt to sign off on the update or protest the changes in a letter.
- MTM Health’s standard agreement allows MTM to change terms, pay rates among them, with a written notice. Silence for 30 days counts as acceptance, so a rejection has to be in writing and on time. Changes needed to follow a law or program requirement do not need your consent at all.
- MAS in New York announces changes by dated provider letter. Its September 11, 2025 letter required real-time GPS data, received within 30 minutes of collection, for all trips from November 10, 2025, and said providers could not attest to trips without it. MAS posts transportation fee schedule updates on the eMedNY and MAS websites.
Give one person the job of reading every broker email and letter the day it arrives. For each change, log the effective date, update your summary sheet, tell the drivers, and put any rejection deadline on the calendar. A 30-day chance to refuse a new rate passes quietly if nobody is watching.
When two rules disagree
Manuals are long, written by several people, and updated in pieces, so contradictions happen. In MTM Health’s Rhode Island handbook, the claims chapter allows 365 calendar days to challenge a denial, while the portal walkthrough later in the same document says eligible denials may be appealed within 90 days. When you find a conflict like that:
- Work to the stricter rule until you hear otherwise.
- Ask your account manager in writing which rule applies, quoting both passages.
- File the answer with your dated copy of the manual.
Build a one-page summary for drivers and dispatch
Nobody reads a 50-page manual on the road. Turn the rules into one page per audience, and replace it every time the broker sends an update. Here is an example built from MTM Health’s Virginia handbook.
| For drivers | For dispatch and billing |
|---|---|
| First pickup: arrive inside the 15-minutes-each-way window around the scheduled time | Return any trip you cannot cover a full day or more before its pickup |
| Never make a rider board before the scheduled time | Will-call vehicle at the door inside 45 minutes |
| Rider not ready within the window: call or text, then follow the no-show procedure | Discharges reached within 3 hours of notice |
| Get the rider to the appointment on or before its scheduled time | Clean claims submitted inside 6 months of the ride |
| Shared rides: 45 minutes is the most extra time any rider can spend aboard | Denied claims appealed within 365 days |
| Tracking running for the whole ride | On any delay, give riders or facilities an updated arrival time, and tell MTM |
| Rider signature on every trip | Watch the scorecard: on time above 95%, provider no-shows below a quarter of a percent |
| Incident or injury: call the office right away | Report every incident and accident to MTM; an unreported one is a 3-point infraction |
Laminate the driver half for each vehicle and use it in onboarding; our driver onboarding checklist and no-show policy template fit alongside it. The office half belongs next to the dispatch screen. When an auditor asks how drivers learn the rules, the page and its revision dates are part of your answer; see passing a broker audit.
Getting rule changes to every driver with HealthRide
When a broker changes a rule, send it to all drivers as a HealthRide announcement and require each one to confirm, then see exactly who has read it and who still needs a reminder. On the trip itself, drivers capture signatures on screen and no-show waits are recorded with the trip, two things broker manuals check closely. See how team chat handles announcements.
Frequently asked questions
- Does the provider manual count as part of my broker contract?
- Often, yes. WellTrans's Indiana agreement makes its provider manual part of the contract by reference and requires providers to follow each amended version. Other manuals work alongside a separate policy document; the MAS manual in New York supplements the state's Medicaid Transportation Policy Manual and is meant to be used with it.
- Where is the current version of a broker manual posted?
- On the broker's provider pages or from your account manager. WellTrans commits to keeping the current version on its website. Brokers that serve several states usually publish one handbook per program, so make sure yours matches your state; MTM Health sets a six-month claim deadline in Virginia and a 90-day one in Rhode Island.
- When a broker changes its manual, how will I hear about it?
- In writing, with a deadline to object. When WellTrans issues a new edition, providers have 5 business days to either sign off on it or object in writing. With MTM Health, a written amendment to the standard agreement, even one changing rates, stands as accepted unless the provider sends a written rejection inside 30 days. MAS uses dated provider letters with a future effective date.
- What should drivers know from the provider manual?
- The rules they apply on every trip: the pickup window, how long to wait and whom to call before a no-show, drop-off timing, will-call and discharge response times, signature rules, wheelchair securement, and the steps after an incident. Put those on one page and review it at onboarding and after every update.
- Two rules in the manual conflict. Which one do I follow?
- Work to the stricter rule and get the broker's written answer on which one applies. One example: the claims chapter of MTM Health's Rhode Island handbook allows a year to appeal a denial, but its portal instructions say 90 days. Keep the broker's reply with your copy of the manual.
