Effective date: June 23, 2026
This organization providing Non-Emergency Medical Transportation (NEMT) and/or ambulance transportation services complies with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as well as applicable Colorado Medicaid requirements administered by the Colorado Department of Health Care Policy & Financing (HCPF).
We recognize that our operations involve the collection, use, and transmission of Protected Health Information (PHI), including but not limited to:
- Member identification and eligibility information
- Trip manifests, pickup and drop-off data
- Mileage and level-of-service documentation
- Physician Certification Statements (PCS) and medical necessity forms
- Claims, billing records, and Medicaid submission data
Safeguards & Compliance Controls
To ensure compliance with HIPAA and Medicaid program requirements, we maintain:
- Role-based access controls limiting PHI to authorized personnel only
- Secure electronic systems for scheduling, dispatch, documentation, and billing
- Encryption and secure transmission of PHI where applicable
- Workforce training on HIPAA, fraud, waste, and abuse prevention
- Documentation standards aligned with Medicaid audit and recoupment review expectations
- Internal review processes to support claim accuracy, completeness, and traceability
- Retention and audit readiness procedures for trip records and billing files
Medicaid & HCPF Audit Readiness
We maintain documentation practices designed to support Colorado Medicaid audit requirements, including:
- Verification of trip necessity and eligibility documentation prior to submission where required
- Retention of PCS and supporting medical documentation in accordance with program rules
- Accurate trip-level billing records that can be traced to source documentation
- Internal review processes to reduce billing errors, duplication, or incomplete claims
- Cooperation with state or contractor audits, reviews, and corrective action plans (CAPs) when applicable
Permitted Use of Information
PHI is used and disclosed only as permitted under HIPAA, including for treatment, payment, and healthcare operations, or as otherwise authorized by the member or required by law or Medicaid program rules.
Commitment to Compliance
We are committed to maintaining ongoing compliance with HIPAA and Colorado Medicaid requirements and continuously improving internal controls to support program integrity, accurate billing, and high-quality transportation services.
For questions regarding privacy practices or compliance policies, please contact our Compliance or Privacy Officer at info@medrideco.com or 719-545-3333.