What is a trip authorization?

A trip authorization (also called prior authorization or a trip number) is the payer's confirmation that a specific ride for a specific member on a specific date is covered. Brokers issue authorizations when they assign trips; fee-for-service states may require the provider or the medical office to request one. The authorization typically fixes the pickup and drop-off addresses, the level of service and the approved mileage.

Why authorizations matter for NEMT

No authorization, no payment. Most denials in NEMT trace back to a trip that was performed without one, or where the actual trip did not match the authorized details: a different address, an extra leg, a wheelchair trip authorized as ambulatory. Drivers should be able to see the authorization details in the driver app and dispatchers should confirm changes with the broker before the ride, not after.

Related terms

• Base Rate
• Denial
• Remittance Advice
• Signature Capture
• No-Show