Missed trips: when the provider, not the rider, fails to show
When a transportation provider never performs a scheduled NEMT ride, it is a missed trip, usually logged as a provider or vendor no-show. Texas counts any booked pickup or return where the van never comes. Tolerance is close to zero: North Carolina and MTM Health's Virginia handbook hold missed trips to 0.25 percent of trips, and brokers charge liquidated damages.
On this page
A missed trip is the provider’s failure
The line is simple. A rider no-show is the rider missing the van. A missed trip is the van missing the rider. Programs define the provider’s version in their own words:
- Texas managed care calls it a provider no show: the van never comes for a booked pickup or a return leg.
- North Carolina uses nearly the same test: the provider does not arrive for the member’s booked trip.
- MTM Health’s Virginia handbook counts vendor no-shows as failing or refusing to complete assigned trips.
- CareOregon needs a verified report from the member, a caregiver, facility staff, or someone else that the provider never arrived.
Sorting one from the other is the broker’s job under CareOregon’s manual, and a rider’s no-show is never charged to the provider.
| Rider no-show | Missed trip | |
|---|---|---|
| Who failed | Rider absent, or refused to ride | Van never came, or the trip was left undone |
| Billable | Usually not | Never |
| What the broker does | Applies its member no-show policy | Counts it against your scorecard and may charge damages |
| Your evidence | Arrival time and the wait you logged | Proof the vehicle was there, or a reason the broker accepts |
Limits and penalties
Missed-trip standards are measured in fractions of a percent:
| Source | Standard | Consequence |
|---|---|---|
| North Carolina Medicaid managed care policy | Vendor no-shows held to 0.25 percent of trips over a contract year | Required in each written contract with a private provider |
| Texas Uniform Managed Care Manual 16.4 | 99 percent of assigned and accepted trips completed, excluding member cancellations and no-shows | Plan-level performance standard |
| MTM Health, Virginia fee-for-service (approved August 2026) | Vendor no-shows below 0.25 percent | An improvement plan, damages, or network termination |
| MTM Health, Rhode Island (updated July 2026) | Green below 0.29 percent, red at 0.5 percent or more | The same range of remedies |
| WellTrans provider agreement (October 2025) | $100 for each vehicle no-show | Deducted from money owed to you |
Late arrivals cost money before they become misses. WellTrans charges $150 when a rider reaches a dialysis appointment late. Past the first hour it adds $50 per hour, counting partial hours.
When a miss is excused
CareOregon may excuse a provider no-show caused by a crash or a sudden vehicle problem, and the brokerage judges each one on its facts. Weather or traffic bad enough to slow everyone on the road is not held against you. WellTrans waives its pickup damages, including the no-show charge, when the cause was outside your control and you reported it before the pickup time.
The common thread is speed. CareOregon expects you to tell dispatch as soon as you know you cannot run a trip, so the broker can try to reassign it, and Louisiana requires immediate notice so the broker can find another provider. A trip handed back in time is a turnback, not a miss. The vehicle breakdown guide covers what to do when a van dies mid-route.
Records that protect you
- Every change, logged. Texas requires the transportation provider to document all cancellations, member or provider no-shows, and rescheduled trips, whoever asked for the change.
- The GPS trail. New York requires each trip’s start point, end point, and the coordinates in between. MTM Health’s Virginia handbook expects more than 90 percent of trips to be tracked by GPS. A trail showing the van at the curb answers a false missed-trip report.
- The incident report. For a real miss, CareOregon’s report covers any harm to the member, any appointment that had to move, and the retraining or other fix you put in place.
Missed trips feed straight into your on-time performance scores, so track them weekly, by driver.
Catching a miss before it happens
Most missed trips start as a late van nobody noticed. HealthRide’s live map shows ETAs and warns when a pickup is running late, and every trip record keeps its timestamps and GPS-recorded miles.
Frequently asked questions
- Is a very late pickup a missed trip?
- It can become one. Texas managed care calls a vehicle excessively late at more than 30 minutes past the scheduled pickup, and the plan must then arrange a backup ride. Colorado lets eligible providers take an urgent trip booked by the facility when a NEMT provider has not picked the member up from an appointment within one hour of the scheduled time.
- Is a missed trip the same as a turnback?
- No. A turnback hands the trip back to the broker early enough for someone else to cover it, within the notice the contract sets. A missed trip is one you kept and never ran. MTM Health scores the two separately, with one metric for turnbacks and another for vendor no-shows.
- Do brokers pay for a missed trip?
- No. Louisiana's manual says a scheduled trip in which nobody was transported is not billable. WellTrans also charges $50 for each trip billed but not performed, unless the provider shows it was a clerical error.
