Downloads

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Title	Description
Transportation Providers FAQs	A PDF document of the Transportation Provider FAQ's	Download
Trip Correction Form	If you experience errors with a trip or with the Prior Authorization procedure codes, please complete this form and fax it to LogistiCare.	Download
Request Form for standing order enrollees’ trips the first two weeks of May	Request to Transportation Providers for their regular Brooklyn Medicaid fee-for-service standing order riders with trips the first two weeks of May	Download
Bulletin - Transporting enrollees without active Medicaid	Transportation Provider alert on enrollees with pending eligibility or monthly spend down requirements	Download
May 1, 2012 Livery and Stretcher fee announcement for New York City medical transportation providers	Livery and stretcher rates, effective May 1, 2012 for New York City transportation providers serving NYC fee-for-service Medicaid enrollees.	Download
New York City Transportation Provider Fee Schedule	The various rates paid NYC transportation providers for the various types of non-emergency medical transports.	Download
NY State Requirements for the Quality of Transportation Services.	Requirements for participation as a Medicaid Transportation Provider.	Download
NYC DOH LGTC Incident Accident Report Form.	NYC DOH LGTC Incident Accident Report Form.	Download

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