Wisconsin In-Network Transportation Provider Checklist

ii)iii)iv)scheduled B-Leg pick up time is considered a “late pick-up”. Themonthly average wait time for all A-Leg pick-ups performed by Providermay not exceed 15 minutes after the scheduled pick-up time and theactual wait time for any specific pick-up may not exceed 30 minutes afterthe scheduled pick-up time. The monthly average wait time for all B-Leg pick-ups performed by Provider may not exceed thirty (30) minutesafter the scheduled pick-up time and actual wait time for any specificpick-up may not exceed 45 minutes after the scheduled pick-up time.However, Provider must ensure that the average wait time for B-Legpick-up of dialysis patients does not does fifteen (15) minutes.The driver shall make his presence known to the Participant upon arrivalat the pick-up address and must wait at least ten (10) minutes after thescheduled pick-up time before the Participant may be considered a “noshow”. If the Participant is not present for pick up, the driver shall notifyProvider’s dispatcher before leaving the pick-up location and documentthe attempted pick-up on the daily trip log.Provider shall deliver the Participant to scheduled medical appointmentswithin fifteen (15) minutes of the medical appointment time as standardpractice, however, an earlier drop off before the appointment time may beacceptable in unusual situations on a case-by-case basis. However, in noevent shall a Participant be dropped off for a medical appointment morethan thirty (30) minutes before the scheduled appointment time, unlessthis is done at the client’s request. Provider shall ensure that Participantsare picked up at prearranged times for the return trip if the medicalservice provider follows a regular schedule. Provider will monitor returntrips to ensure Participants are delivered to their return destination intimely manner. The prearranged times may not be changed by Provider orthe driver without prior permission from LGTC. Based on input fromhealthcare facilities, LGTC reserves the right, in its sole discretion, tomeasure on-time performance of Provider by reference to the on-timedelivery of Participants to scheduled medical appointments.For “will call” return pick-up reservations from a medical appointment,the Provider shall arrive within one (1) hour after the time Provider isnotified that the Participant is ready, or by the close of the business dayfor the medical service provider, whichever is earlier.v) If a delay of fifteen (15) minutes or more occurs in the course of pickingup scheduled riders, Provider must contact waiting Participants at theirpick-up points to inform them of the delay and the expected arrival timeof the vehicle. Provider must advise scheduled riders of alternate pick-uparrangements when appropriate.vi)vii)If a delay occurs that will result in a Participant being late for a medicalappointment, Provider must contact LGTC who will notify the medicalprovider of the late arrival.For same day hospital discharge reservations, Provider shall pick-upWisconsin NET ProgramVersion: March 25 2011Page 5