Transportation

• Sunshine Health contracts with Alivi to administer all non-emergent medical transportation services for our Medicaid, Sunshine Health Pathway to Shine Specialty Plan (CWSP), Sunshine Health Mindful Pathways Specialty Plan (SMI), Long Term Care, Sunshine Health Power to Thrive Specialty Plan (HIV) and Comprehensive Long Term Care members.
• Sunshine Health contracts with MTM to administer all non-emergent medical transportation services for our Children Medical Services (CMS) Health Plan members.

Alivi serves as Sunshine Health’s administrator for all non-emergent transportation operations for our Medicaid, Sunshine Health Pathway to Shine Specialty Plan (CWSP), Sunshine Health Mindful Pathways Specialty Plan (SMI), Long Term Care, Sunshine Health Power to Thrive Specialty Plan (HIV) and Comprehensive Long Term Care members. This includes verifying the member’s eligibility, trip purpose and mode of transportation. The following transportation services are offered at no cost to Sunshine Health members:

• Outside the county in which they live as long as it is within the state of Florida.
• Outside the state of Florida to contiguous states or more than 100 miles one way when authorized by Sunshine Health.
• From an emergency room to the member’s residence.
• From one hospital to another hospital.
• From a hospital, skilled nursing facility (SNF) or rehabilitation facility to the member’s home.
• From a member’s home or Assisted Living Facility (ALF) to a SNF.
• From a SNF to Covered Person’s home or ALF.
• From ALF to ALF.
• From a SNF to a covered service and back to the SNF.
• From a SNF to another SNF.
• From a member’s home to hospital for a planned elective procedure or service.
• To a pharmacy as a non-medical trip.
• From a member’s home and back to other covered services.
• Services are available 24/7, 365 days a year. There are no limits on the number of non-emergent medical or Long-Term Care transportation services a member may receive.
• Three non-medical trips per month, like shopping or social events, within member’s home county or within 30 miles of member’s home county.
• In addition to three social non-medical trips, Long-Term Care members receive three Pathways to Purpose trips for volunteer/mentoring opportunities specifically/only.

• Outside the county in which they live as long as it is within the state of Florida.
• Outside the state of Florida to contiguous states or more than 100 miles one way when authorized by Sunshine Health.
• From an emergency room to the member’s residence.
• From one hospital to another hospital.
• From a hospital to skilled nursing facility (SNF) or rehabilitation facility.
• From a hospital, skilled nursing facility (SNF) or rehabilitation facility to the member’s home.
• From a member’s home to SNF.
• From a SNF to a covered service and back.
• From a SNF to another SNF or a rehabilitation facility.
• From a member’s home to/from a Group home or Residential Treatment Center.
• From a Residential Treatment Center to a Group Home.
• From a member’s home to hospital for a planned elective procedure or service.
• To a pharmacy after a provider appointment or upon discharge from an acute hospital, SNF, or rehabilitation facility.
• Urgent/Same Day appointments/Facility Discharges and Rider Assistance services are available 24/7, 365 days a year.
• Two non-medical trips per month, like shopping or social events, within member’s home county or within 30 miles of member’s home county.

As a Sunshine Health network provider, you may be asked to identify transportation needs, set up standing order trips, or assist members with completing their mileage reimbursement trip logs. Your transportation-based activities on behalf of our members will be managed through Alivi and MTM’s secure, online portals. We encourage you to visit the Alivi or MTM website to request or create your account. 

Members can call Alivi at any of these numbers or schedule trips through their mobile app (see below). Member can call MTM at the number below or schedule trips through MTM secure member portal. If the member opts to use the online portal, they must schedule one initial trip through the call center first..

There are three types of transportation services available to members:

1. One-time transportation requests. Routine appointments require a 24 hour notice and scheduled one (1) business day prior to the appointment.
   • Health plan members can make reservations one of two ways:
     • Call the Reservation Centers (see above)
     • Access either the Alivi mobile app (see below) or MTM secure member portal.
2. Standing orders are trips that are on a recurring, regular basis. Facilities and providers will schedule standing orders on behalf of plan members. These requests can be processed through either calling Alivi or through MTM’s provider secure portal. If you need assistance completing a standing order request, please call either Alivi’s Reservation Centers (see above) or MTM at  1-855-824-5695.
3. Will Call/Ride Assist: If a trip is arranged and the return time is uncertain, it is scheduled as a “Will Call.” When the member is ready to be picked up, they call Ride Assist. Hours of operation are 24/7/365. Expected response time is up to 60 minutes.

Alivi and MTM will provide four (4) modes of non-emergent transportation:

• Ambulatory for members who can enter and exit a vehicle with minimal to no assistance. Ambulatory vehicles include public transit buses, vans, sedans, mini-vans and taxis.
• Wheelchair for members who have a disabling physical condition that requires the use of a wheelchair, walker, cane, crutches or brace and are unable to use a taxi or public transportation.
• Stretcher for members who need transport assistance to and from the vehicle and provider in a reclining position. No flashing lights, sirens or emergency equipment is required.
• Non-Emergent Basic Life Support/Advanced Life Support for members who need basic or advanced life support services to be safely transported. Conditions that may warrant this type of transportation include when the member is continuously dependent on oxygen that must be administered by trained personnel, receiving IV treatment, is heavily sedated or comatose, or classified as an American Heart Association Class IV patient with heart disease.

Yes. Reimbursement is available per mile. To qualify for reimbursement, the member must call Alivi Monday through Friday between 8 a.m. and 5 p.m. Eastern and MTM between 8 a.m. and 7 p.m. Eastern. All reimbursement requests can be made up to 30 days in advance but no later than the day of the appointment. Back dated mileage reimbursements are not allowed.

When the member calls in their reservation, they should provide the vendor with the name and mailing address of the person to whom the reimbursement is to be made payable. Once the trip is verified, the member will be issued a Reference Number. This Reference Number becomes the member’s Mileage Reimbursement Trip/Job number. Members will only be reimbursed for trips on their Mileage Reimbursement Trip Log that includes this number.

Member must not have another means of transportation to qualify. Gas mileage reimbursement is an option if member has someone that can assist with transportation. Members, spouses or parents/guardians cannot get gas mileage reimbursement.

Mileage Reimbursement Trip Logs for Sunshine Health and Sunshine Health specialty plan members should be sent to Alivi for payment at:

Fax: 1-855-621-8962
Attention: Member Services Department (Mileage Reimbursement)

Or

Email: Memberservices@alivi.com
Subject Line: MemberFirst_LastName

All Mileage Reimbursement Trip Logs for CMS members should be mailed to MTM for payment at:

MTM Attention: Trip Logs
16 Hawk Ridge Drive
Lake St. Louis, MO 63367

Each log must be filled out correctly and completely before the member will be reimbursed. Fields include the trip date, medical provider name and phone number, physician/clinician signature, and total number of miles driven associated with that particular visit. Each date of service must have a physician or clinician signature in order for the reimbursement to be approved and must be confirmed with the physician’s office before payment will be made. 

Yes. Members are able to schedule the status of trips using Alivi’s mobile app for iOS and Android users.

Yes, Members are able to schedule the status of trips using MTM’s mobile app for iOS and Android users.