:: Red Cliff Band of Lake Superior Chippewa

Medical Mileage

Program Description:
Reimbursement for transportation mileage to and from a location where qualified recipient receives a Medicaid covered service. Local Mileage: Is anywhere between Red Cliff and Ashland Non-Local Mileage: Outside of the Local area Reimbursement per mile is as of November 2003:
$ 0.24 per mile for family member
$ 0.33 per mile for non-family member
$ 0.35 per mile for two (2) or more non-family clients on one trip

Eligibility:

Clients must be eligible for Medicaid for the period of time that reimbursement is required.
Clients must receive prior-authorization for all Non-emergency medical trips through the Medical Mileage Clerk, in order to be reimbursed. If an emergency does occur client must notify the medical mileage clerk within 72 hours after the trip, for reimbursement.
Verification must be signed by a receptionist, nurse, or physician and must be attached to the medical mileage reimbursement form which you obtain at the front desk in the lower level of the Tribal Office.
Local Medical Mileage transportation Forms are to be turned in no later than the fifth (5th) of each Month. Medical Mileage Clerk will process the forms by the 10th of each month. Checks may be available after the 10th and no later than the 15th of each month.
Non-Local Medical Mileage forms are to be completed and turned in no later that the 3rd day after the scheduled date of the appointment or it can not be processed until the 5th day of the following month.
There are specific areas on the billing forms that the client and the driver’s must fill out.

Forms can be obtained at the receptionist Front Desk in the Lower Level of the Tribal Administration Building. Each form is for one individual client. You may not have multiple clients on one form.

Program Contact Info:
Deb Morris
Phone - (715) 779-3706 ext 259
Email: dmorris@redcliff-nsn.gov

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