How to switch NEMT software without a bad first week

Before you look at exports, list what your company depends on every day. Not every feature of the old system: the ones you would notice by noon if they disappeared.

• Riders, with their needs, equipment, language, addresses and notes for the driver.
• Payers and their rates: per leg, per mile, wait time, attendants, by space type and time of day.
• Authorizations, with their numbers, units and end dates.
• Standing orders, such as dialysis three days a week, with their exceptions.
• Vehicles with their space types and capacity, drivers with their credentials and expiry dates.
• Runs, zones, common locations such as clinics and dialysis centers.
• Broker trip files and the column layouts they come in.
• The trip sheets and invoices each payer expects, in their format.

This list is the test for the new system. If it cannot hold one of these, you will find out on day one.

Get every list above out of the old system as CSV or Excel, and ask your current vendor how before you give notice. Also export about three months of trip history with actual pickup and drop-off times. That history lets the new system check its own times against how your vans really drive, and it is your record if a payer asks about an old trip.

Expect to clean things up. Duplicate riders, old addresses, rates that changed but never got end dates. Moving is the cheapest time to fix them, because every record is being looked at anyway.

The new vendor will hold rider health information, so it needs a business associate agreement with you before any real data goes in. Under HIPAA, a covered entity that shares protected health information with a business associate must have that contract in place. If you are unsure whether it applies to you, ask your compliance adviser.

The most useful week of a switch is one where nothing depends on the new system. Keep dispatching and billing in the old one. Each day, plan the same trips in the new one too, and compare:

• Did every trip come across, including standing orders and will-calls?
• Are the riders, addresses and space types the same?
• Would the times and runs make sense to your dispatcher?
• Do the charges match, leg by leg, for each payer? A difference usually means a rate rule, a mileage rounding setting or a field typed differently in each system.

Fix each difference at the setting, not the trip, then compare that day again. When a few days in a row agree, you have proof, not a promise, that the new system is ready.

Choose a day, do not let it choose you. A good go-live day is light, falls after a full shadow week, and is not the day you send the month's bills. Before it:

1. Roll standing orders forward in the new system for the weeks ahead, and turn them off in the old one, so nobody gets two vans or none.
2. Get the driver app onto every phone and have each driver sign in once before the day. Show them the run, a pickup, a signature, a no-show. Ten minutes per driver beats an hour of calls on the day.
3. Set up rider texts in advance. Text messages from a business number need carrier registration, which takes time.
4. Make sure the broker files for go-live day are imported in the new system and not the old.
5. Have someone who knows both systems on the phone for the first two days.

Billing is where a switch can quietly cost money. A simple rule avoids most of it: bill each trip from the system it was performed in. Trips before go-live are billed from the old system; trips from go-live on, from the new one. Keep the old system open, at least read-only, until its last claims are paid or written off and its remittances are posted.

Filing deadlines do not pause for a software change. California expects an original Medi-Cal fee-for-service claim within six months after the month of service, and each plan or broker sets its own limit, which can be shorter or longer. Put the old system's last billing run on the calendar before go-live, not after. Our guide to Medi-Cal NEMT billing codes covers what each claim needs.

Expect questions, not disasters, if the steps above were done. Check the first days the same way you checked the shadow week: every trip done, every leg with its proof, every charge right. Watch will-calls and late pickups closely, since a new board is when dispatchers are slowest. Will-call returns has a checklist for those.

Last, make sure you can leave. Ask the new vendor how you would export all your data, including signatures and documents, if you ever stopped using it. The answer tells you a lot about how the switch will go.

MileCall imports your setup from your current software's exports: vehicles, drivers, runs, locations, riders and rates. Broker files come in as CSV or Excel, with a column mapping MileCall remembers per format. A shadow week plans each day beside your current plan and compares them leg by leg, on statuses, times, miles and charges, and you go live when the two agree. Settings › Export all data gives you every table as CSV and JSON, with signatures and documents as files, whenever you want. See Switching to MileCall.

1. Business associates (U.S. Department of Health and Human Services)
2. 45 CFR 164.504(e): business associate contracts (Electronic Code of Federal Regulations)
3. Welfare and Institutions Code section 14115 (Medi-Cal claim submission time limits) (California Legislative Information)

This post explains how things work in general; it is not legal, medical or billing advice. Rules change and differ by payer, so check your payer’s current manual and your contract before you rely on any detail here.