NEMT proposal template for facilities: the cover letter, service plan, price table, and proof to attach
Overview
A NEMT proposal for a facility is a short document that tells a hospital, nursing home, or dialysis clinic which rides you will run, how fast you respond, what each ride costs, and what proof backs you up. It holds a cover letter, a service plan, response times, insurance and screening proof, a price table, references, and terms.
On this page
How to use this template
Use this proposal when a facility has asked you for something in writing, or when a first meeting went well and you want the decision-maker to have the facts on one desk. It is built for a hospital, a nursing home, a dialysis clinic, or a senior community, and it runs three to five pages with attachments.
- If the facility sent you an RFP, answer the RFP in the order it sets and treat this form as a source of text. The RFP template shows what the other side wrote.
- If you have not met anyone yet, start with a one-page introduction letter. A proposal is the second document.
- Leave out any line you cannot back. An on-time rate with no recorded times behind it costs you more than an empty line.
- Take prices from your own sheet. Build the price table from your rate sheet so a signed proposal and a later invoice agree.
For the wider picture of finding and keeping facilities, see how to get NEMT facility contracts. The proposal that wins becomes the facility transportation agreement.
The proposal
Cover letter
Dear ____,
Thank you for meeting with us on ____. We propose to provide ____ (levels of service) rides for ____‘s patients or residents, beginning ____.
You told us the hardest part of your current rides is ____. Our plan for that is ____. We will confirm every request within ____ minutes and report each month on on-time rides, waits, complaints, and incidents.
This proposal holds our service plan, response times, proof of insurance and screening, prices, and references. I will call you on ____ to answer questions.
Sincerely, ____ (name, title, direct phone, email)
1. About our company
| Item | Entry |
|---|---|
| Legal name and address | |
| Years running non-emergency rides | |
| Service area | |
| Hours of dispatch and driving | |
| NPI and Medicaid enrollment | |
| Brokers and health plans we serve | |
| State licenses and permits (numbers and dates) |
2. What we heard from you
Write three to five sentences in the facility’s own words: what rides it books, when the trouble starts, and what it wants fixed. Use what the discharge planner, social worker, or administrator told you, not your general pitch. It shows the reader you listened.
3. Rides and vehicles we will provide
| Vehicle type | Number | Lift or ramp | Wheelchair positions |
|---|---|---|---|
| Ambulatory sedan or van | |||
| Wheelchair van | |||
| Stretcher van |
Add a line on each service: ambulatory, rider’s own wheelchair, company wheelchair, stretcher with a two-person crew, escort or attendant riding along, and door-through-door help. Say which you offer. For wheelchair vehicles, state that the lift and securement meet 49 CFR 38.23 and give the date of the last state inspection.
4. Response times we commit to
| Situation | Our commitment | How we will show it |
|---|---|---|
| Confirming a request | Within ____ minutes | Time stamp on each confirmation |
| Scheduled pickup | ____ minutes before to ____ minutes after the set time | Arrival times in the trip record |
| Same-day request | Vehicle at pickup within ____ hours | Request time to arrival time |
| Will-call return | Vehicle at pickup within ____ minutes of your call | Your call time to arrival time |
| Discharge | Vehicle at the unit within ____ hours of your call | Same |
Write only numbers your fleet can meet on your busiest day. MTM Health’s Virginia handbook shows what a missed standard can cost: a hospital discharge vehicle must arrive within three hours of the call, and missing it results in liquidated damages.
5. Drivers and screening
- Background and driving record checks. Type, provider, and the date for every driver on this account.
- Training. Courses and completion dates: passenger assistance, wheelchair securement, CPR, privacy, and any facility-specific orientation.
- Exclusion checks. We search the OIG exclusion list and SAM.gov for the company, its owners, and every driver each month. Date of the last search: ____.
- Sample driver file. Attached, with personal details removed.
6. Insurance
| Coverage | Our limit | Policy ends |
|---|---|---|
| Commercial auto liability | $ | |
| General liability | $ | |
| Workers’ compensation and employer’s liability | $ | |
| Umbrella or excess | $ | |
| Privacy and data breach, if we hold patient information | $ |
The certificate from our agent is attached. We name ____ as an additional insured if you require it.
7. Reporting and review
We send a monthly report in the first week of each month. It lists rides by level of service, on-time pickups and arrivals and the definition we use, will-call and discharge waits, rides that did not run and why, complaints, and incidents, with trip numbers in place of names. We meet every ____ months to review it. A sample report is attached (report template).
8. Privacy
Patient information is used for one purpose: arranging, providing, and billing your rides. Ride details reach drivers through ____, never through personal text messages. If patient information is ever used or shared without permission, we notify you within ____ days. We will sign your business associate agreement if you ask ☐ yes ☐ no.
9. Prices
| Item | Price | Note |
|---|---|---|
| Ambulatory trip, one way | $ | Loaded miles included: ____ |
| Wheelchair trip, one way | $ | Loaded miles included: ____ |
| Stretcher trip, one way | $ | Loaded miles included: ____ |
| Each extra loaded mile | $ | Distance taken from ____ |
| Waiting after ____ free minutes | $ for each ____ minutes | Billed in blocks |
| Escort, stairs, after hours | $ | In the attached rate sheet |
| Late cancellation or no-show | $ | Under the attached policy |
Every price is all-in unless a line says otherwise, and prices stay firm for ____ days.
10. Our first 30 days
- Day 1 to 5: sign the agreement, send the insurance certificate, and set up your booking contacts.
- Day 6 to 10: load your standing rides and ride-along on your three hardest runs.
- Day 11 to 20: run the full schedule with a named dispatcher who answers your calls.
- Day 30: send the first report and meet to review it.
Replace the days and steps with your own plan.
11. What could go wrong, and our plan
| Risk | What we do |
|---|---|
| A driver calls out | |
| A van breaks down with a rider on board | |
| A discharge surge on a busy afternoon | |
| A rider is not ready at pickup |
12. References
| Facility | Contact and phone | Rides we provide | Since |
|---|---|---|---|
13. Terms and exceptions
This proposal holds for ____ days. We propose a term of ____ with ____ days’ written notice to end it. Invoices go out ____ and are due ____ days after the invoice date. Any requirement we cannot accept is listed here with the reason: ____.
Signed: ____ Date: ____
An example month, priced
A price table is easier to compare when it ends in a total. Add one line to your proposal that prices the facility’s own month. Here is a made-up month for a nursing home, using these example rates: wheelchair $50 including the first 5 loaded miles, $3.00 for each added mile; stretcher $140 including the first 5 miles, $4.50 for each added mile; waiting $12 for each 15 minutes after 15 free minutes; late cancellation $25.
| Line | Count | Price each | Amount |
|---|---|---|---|
| Wheelchair leg, 8 loaded miles | 36 | $59.00 | $2,124.00 |
| Stretcher leg, 12 loaded miles | 8 | $171.50 | $1,372.00 |
| Waiting, 30 minutes on each | 6 | $12.00 | $72.00 |
| Late cancellation | 2 | $25.00 | $50.00 |
| Month total | $3,618.00 |
The wheelchair price is $50 plus 3 added miles at $3.00. The stretcher price is $140 plus 7 added miles at $4.50. Waiting of 30 minutes with 15 free leaves one 15-minute block. Swap in the facility’s real volumes and your own rates.
Price this account the way you price any customer of similar size. OIG’s guidance for nursing facilities warns against a link between a low price on services the facility pays for and the facility’s referral of business that a company can bill to a federal health care program, and it lists prices below those offered to similar-volume customers among the suspect arrangements. The anti-kickback guide explains where the lines sit.
What a facility’s own RFP asks bidders to do
When a hospital writes its own request, its rules shape your proposal. University Hospital’s 2026 request for non-emergency patient transportation shows what to expect.
- Real plans, not echoes. It asks for a plan that is realistic and attainable, tells bidders that repeating its tasks back is strongly discouraged, and asks each bidder to list problems it expects and its answer to each.
- References with weight. At least three, preferably five, from customers with similar or greater ride volume, with contact names and phone numbers.
- Prices that hold. Bidders are asked to hold prices firm for 120 days so an award can be made, and the price sheet covers all costs.
- Proof early. Copies of vehicle registrations and insurance cards go with the bid, the certificate of insurance is due within ten days of notice of intent to award, and no service starts until the hospital has it.
- Background checks with a date. A criminal history check counts if it was done during the contract or no earlier than six months before it starts.
- Insurance that outlasts the contract. Liability coverage stays in force for 90 days after the work ends. The hospital’s limits include $2 million general liability, $1 million auto, $1 million excess, and $5 million for privacy and technology risk, with the hospital as an additional insured.
Those limits are one hospital’s. Another facility will set its own, so get the insurance exhibit before you price, as the hospital vendor guide explains.
Commitments you can keep
Every response time in section 4 is a promise a facility can hold you to. Some programs attach money to the numbers: MTM Health’s Virginia handbook lets providers at 95 percent on-time in a calendar quarter qualify for an incentive pool and charges liquidated damages when a discharge vehicle takes more than three hours. A facility that sees numbers like these elsewhere will ask for similar ones from you.
Set each commitment from what your fleet did last quarter, not from what a competitor says. If your will-call returns average 35 minutes today, commit to 45 and use the monthly report to show you beat it.
Sending the proposal from HealthRide
A company that runs on HealthRide can fill sections 4 and 7 from its own trip records: each trip logs its scheduled and actual times and GPS-recorded miles, on-time performance is tracked on every trip, and the trip log exports as a spreadsheet or a print-ready PDF. Your facility’s staff also get a portal where they can request rides, watch vehicles live, and view and pay invoices. See reports.
Frequently asked questions
- What should I attach to a facility proposal?
- Attach the certificate of insurance sent by your agent, a vehicle list, one driver file with personal details removed, your references, and your rate sheet. University Hospital's 2026 request also wanted the registration and insurance card for each vehicle with the bid, plus at least three references, preferably five, from customers with similar or greater ride volume. If the facility requires a business associate agreement, send it signed.
- How long should the proposal be?
- For a nursing home or clinic that did not issue an RFP, three to five pages plus attachments is usually enough. A facility's own RFP sets the format, so answer its sections in its order. University Hospital's request asks for a technical proposal, an organization and experience section, and a cost proposal, and discourages simply repeating the requirements back.
- Should I put prices in a first proposal?
- Yes, from your rate sheet, because a facility cannot compare a proposal without a price. Charge it what you would charge any similar customer. OIG's November 2024 guidance for nursing facilities lists below-cost deals, prices below those offered to similar-volume customers without federal referrals, and discounts or free items paired with exclusive agreements or promised referrals as suspect.
- What if the facility's RFP asks for terms I cannot accept?
- Ask during the question period, before the deadline. University Hospital's 2026 instructions to bidders call exceptions the most serious form of non-compliance, say a material exception is cured only by withdrawing it, and note that a proposal taking exception to its 45-day payment terms will likely be judged non-responsive. Raise a concern as a question first.
- Will my proposal become a public record?
- It can, when the buyer is a public hospital. University Hospital's request says information bidders submit is public after award unless a state open records exemption applies, and it asks bidders to mark anything they believe should stay confidential. A private facility has no such rule, so ask about confidentiality before you send pricing or driver records.
- How do I prove my on-time rate?
- Give a three-month result from recorded arrival times, name the period, and state the definition you used. For a yardstick, MTM Health's 2026 Virginia handbook accepts a first pickup up to 15 minutes early or late, expects drop-off no later than the appointment, and lets providers at 95 percent on-time or better in a calendar quarter qualify for an incentive.
- Does the facility need proof that my company is not excluded?
- Expect to be asked for it. OIG says an excluded party can receive no payment from federal health care programs for what it furnishes. When a federal award recipient awards a contract expected to reach $25,000, 2 CFR 180.220 and 180.300 have the buyer verify the contractor is not excluded by checking SAM.gov, collecting a certification, or adding a clause. Keep your OIG and SAM.gov results on file.
