A driver is running late: the dispatcher's playbook for late NEMT pickups

When a pickup counts as late

A pickup turns late when the driver misses the window the contract allows. In the broker manuals cited on this page, that window closes 15 minutes after the booked time. MTM’s Virginia handbook (approved August 10, 2026) and the MAS provider manual for New York also count an arrival up to 15 minutes early as on time, and MTM’s Rhode Island handbook and Georgia’s NEMT manual treat any miss of more than 15 minutes as untimely.

The drop-off runs on its own clock. Virginia requires riders on scheduled and recurring trips to get there by the appointment time. A driver can hit the pickup window and the rider can still walk into the clinic late.

So every trip that slips raises two checks: whether the driver can still reach the rider inside the pickup window, and whether the rider can still make the appointment. The answers decide which move you make below. For how these clocks are scored across a month, see NEMT on-time performance.

Catch the delay before the rider notices

The earlier you see a late trip, the more options you have. A dispatcher who hears about it at the last minute can only apologize. One who learns about it 30 minutes ahead can usually fix it.

Watch the next pickup, not the current one. For each driver, compare the expected arrival at the next stop with the end of that stop’s window. A driver who is 10 minutes behind on the first leg of a four-leg run can easily be 30 minutes behind by the last one.

The usual warning signs:

• A late start. The first run left the lot late, or the driver started far from the first pickup.
• A long stop. A rider was not ready, boarding took longer than planned, or a pharmacy stop or other booked wait ran over. CareOregon’s provider manual caps those booked waits at 15 minutes and has the provider tell the brokerage when one will run longer.
• A will-call return dropped into a tight run. Every pickup after it moves back. See how to handle will-call trips.
• Traffic, a crash, or weather between the driver and the next pickup.
• A status that never came in. The driver has not marked the last pickup or drop-off, so you cannot tell where the run stands. Call before you assume it is on time.

Drivers are your earliest warning. In Texas, a driver who is going to arrive late has to say so at once, so the plan or provider can check with the medical office that the rider can still be seen. Make that your company rule too: a driver who knows a window will be missed tells dispatch as soon as it is safe and legal to do so. Texas drivers may not use a phone behind the wheel for anything but directions on the current trip, so they call in from a stop. Set up that channel ahead of time with a clear dispatcher and driver communication routine.

Decide: move the trip or keep it and warn

Once the delay is real, you have four options. Take the first one that works.

Keep these rules in mind whichever move you make.

1. Confirm any handoff. When you reassign, tell the new driver and confirm they have accepted it before it leaves the late driver’s run.
2. Match the level of service. CareOregon lets a provider swap vehicle types without approval only when the substitute still fits the rider, for example a wheelchair van that also has regular seats taking a sedan rider. Check the level of service before you move a wheelchair or stretcher rider.
3. Leave the times alone. CareOregon requires brokerage approval before a provider changes the times or addresses on a trip. Report the delay instead of editing the trip.
4. Keep broker trips in your own fleet. MTM’s provider agreement (the 2023 version on Pennsylvania’s site) does not let you pass work to another company without MTM’s written approval. Ask the broker to reassign rather than calling another company yourself.
5. Never buy back minutes with speed. MTM’s Virginia handbook states that schedules never justify unsafe driving. A crash costs far more than a late pickup.

Three calls: rider, facility, broker

Every late trip gets up to three calls, in this order.

1. The rider or caregiver. Give a specific new arrival time. Rhode Island’s MTM handbook (updated July 1, 2026) and Georgia’s NEMT policy manual (July 1, 2026) both require the provider to reach riders at their pickup points about the delay and to offer alternate pickup arrangements when appropriate. Louisiana’s Medi Trans manual (revised February 2025) has the provider try to reach waiting riders with an expected arrival time once a delay hits 30 minutes.
2. The facility. When the delay threatens the appointment, call the clinic or center and ask whether the rider can still be seen. Virginia’s handbook tells providers to give affected riders or facilities the revised arrival time. Dialysis centers book each patient into a fixed chair time, so call the center first when a dialysis rider is running behind.
3. The broker. Virginia has providers report the delay to MTM. Under MTM’s standard agreement, a serious delay that puts a rider behind for the appointment gets reported to MTM at once. It also has the provider arrange another way to finish the trip on time if the visit can still go ahead. The MAS manual asks for advance word of delays so everyone involved hears before the rider does.

Sample wording for the rider call:

“Hello Ms. Carter, this is the transportation office. Your driver is about 20 minutes behind and should reach you by 9:40. If that is too late for your 10:15 appointment, we will call the clinic now and call you right back.”

Broker notice rules and backup clocks

Contracts set how fast you must speak up and when someone else takes over the trip. These are the published rules in several current manuals and contracts.

The backup clocks matter because they mark the point where the trip can leave your hands. A dispatcher who calls the broker at minute 15 with a plan is part of the fix. When the rider calls the broker first, the backup starts without you. CareOregon counts it as a provider no-show when a verified report from a rider, caregiver, or facility says the provider never arrived.

Lateness also costs money directly. MTM’s standard agreement puts it plainly: when lateness keeps the rider from being seen, the provider can face a no-show penalty or lose the fare. The Medi Trans manual lets the rider cancel at no cost when the vehicle shows up after the appointment time.

Record the cause on every late trip

Write down why each late trip was late, on the day it happens. The record protects you in a dispute and tells you what to fix.

Brokers ask for it. The Medi Trans manual requires a daily report of late pickups with the reason. In Texas, providers log each cancellation, no-show, and rescheduled trip, no matter who asked for the change. CareOregon may excuse a missed pickup caused by a crash or a sudden mechanical failure, and it does not hold providers responsible for abnormal weather or traffic that slows everyone on the road. Those excuses only help when your record shows the cause and the time you reported it.

Use a short, fixed list of cause codes so you can count them later:

• Late start from the lot or the first pickup
• Previous rider not ready or slow to board
• Will-call or same-day trip added to the run
• Crash, road closure, or heavy traffic
• Weather (see the bad weather policy guide)
• Vehicle problem (see van breakdowns with riders aboard)
• Trip assigned late by the broker
• Wrong address, gate code, or entrance
• Driver error or route choice

With each code, log the minutes late, who you called and at what time, and any broker reference number. CareOregon marks a same-day trip that reached a provider already late as assigned late and does not penalize the late pickup. Your own log should show the same facts.

Stop the same trips from running late again

Late trips repeat. The same run, the same return pattern, or the same bottleneck shows up week after week. Review the late log once a week, sorted by cause code, and fix the biggest cause first. The NEMT KPIs guide covers how to track the rate over time.

Do not catch up by picking riders up early. MTM’s Virginia handbook says riders cannot be made to get in before the booked pickup time, and CareOregon forbids drivers from making riders leave ahead of schedule. The MAS manual allows an early start only when both the rider and driver consent. The dispatch workflow guide shows where these checks fit in a dispatcher’s day.

Catching late trips sooner in HealthRide

HealthRide flags a late pickup on the live map, the fleet list, and the dispatch board at the same time, so the dispatcher sees it early enough to fix it. You can drag the trip to another driver on the dispatch board in one motion. Riders and facilities get a text with a link that shows when the driver will arrive.