Common use of Verifying Eligibility for NEMT Services Clause in Contracts

Verifying Eligibility for NEMT Services. The Contractor shall screen all requests for NEMT services to confirm each of the following items: (a) That the person for whom the transportation is being requested is an OHP enrollee and enrolled in the Contractor’s CCO; (b) That the service for which NEMT service is requested is an OHP covered service or for flex services as determined by the CCO; (c) That the enrollee is eligible for services; and (d) That the transportation is a covered NEMT service.

Verifying Eligibility for NEMT Services. The Contractor shall screen all requests for NEMT services to confirm each of the following items: (a) That the person for whom the transportation Transportation is being requested is an OHP enrollee Member and enrolled in the Contractor’s CCO; (b) That the service for which NEMT service is requested is an OHP covered service or for flex services as determined by the CCO; (c) That the enrollee Member is eligible for services; and (d) That the transportation Transportation is a covered NEMT service.