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Attachment MODEL CONTRACTBETWEENCOUNTY OF ORANGEANDCONTRACTOR FOR SENIOR EMERGENCY MEDICAL TRANSPORTATION SERVICES SERVICE AREA __CODA# N/AGAIN # N/PROGRAM/SERVICE TITLE Senior Emergency Medical Transportation

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How to fill out nonemergency medical transportation

01

Contact the nonemergency medical transportation provider

02

Provide your personal information including name, address, and contact number

03

Provide your medical information including condition, mobility needs, and any special requirements

04

Schedule the transport service as per your medical appointment

Who needs nonemergency medical transportation?

01

Individuals who have medical conditions that require regular visits to healthcare facilities

02

Patients who are unable to drive themselves or use public transportation due to their medical condition

03

Elderly individuals who require assistance in transportation to medical appointments

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What is nonemergency medical transportation?

Nonemergency medical transportation refers to transportation services provided to individuals who do not require immediate medical attention and are not in life-threatening situations.

Who is required to file nonemergency medical transportation?

Healthcare providers, insurance companies, and transportation providers are required to file nonemergency medical transportation.

How to fill out nonemergency medical transportation?

Nonemergency medical transportation can be filled out by providing details such as the patient's name, date of birth, medical condition, required mode of transportation, and destination.

What is the purpose of nonemergency medical transportation?

The purpose of nonemergency medical transportation is to ensure that individuals who are unable to transport themselves to medical appointments or treatments can receive the necessary medical care.

What information must be reported on nonemergency medical transportation?

Information such as the date and time of the appointment, the reason for transportation, the distance to be traveled, and any special requirements of the patient must be reported on nonemergency medical transportation forms.

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