How to write a NEMT proposal template

What to take away

Most proposals in this trade are a service description with a price at the end. The reader, usually a scheduler or an administrator, is trying to answer one question: will this reduce the number of problems that reach my desk? Write to that question.

Section one: what you understood

One short paragraph restating their situation. Their trip patterns, their appointment times, the failures they described, and what they said they need.

Use their words. This paragraph does two things: it proves you listened, and it gives them the chance to correct you before anything is priced. The material for it comes out of the conversation described in how to run a useful NEMT discovery call.

Section two: capacity

Say what you can cover and when, in plain terms: how many vehicles of which type, on which days and hours, with what reserve when a vehicle is off the road.

If serving them fully requires something you do not yet have, say so and propose a start date that reflects it. This is the section that separates operators who have done the arithmetic from those who have not, and bookers can tell.

Section three: scope

The part that becomes the contract. For each trip type you are proposing to serve, these are the terms to state, and they run in this order:

Item eight is the one that protects everybody. State that a trip requiring equipment or handling you have not agreed to provide will not be attempted, and that you will contact the booking party instead. A driver improvising at a doorway is the outcome this sentence exists to prevent.

Section four: how the service will run

Half a page, not more. Intake and what you will need from them, how a trip reaches a driver, what happens at the door, and how the day's exceptions are handled and communicated.

Spell out how a trip reaches a driver: who assigns it, how the day's trips are routed and sequenced, the booking and scheduling window, and the wait-time rule the driver follows at the door before a trip is treated as a no-show.

The reader is checking whether you have a process or an intention. The process itself is set out in the operations and workflow guide.

Section five: evidence, attached

Attach rather than describe. A certificate of insurance direct from the insurer. The authority you hold and are entitled to show: your state Medicaid provider enrollment letter or number, the operating permit or license your state's motor carrier or DOT office issues for this service, and, where the state runs the benefit through a broker such as Modivcare or MTM, your enrollment and contract with that broker. The vehicle list with the accessibility equipment fitted to each one, and the lift or ramp specification for each. Training and competency records in summary form. Your written procedures for the situations that worry them.

What you are required to hold and permitted to show about your people is set by your state Medicaid program, the broker it contracts with and your insurer, which is mapped in the licensing and compliance guide. The training evidence comes from the competency records described in the hiring and training guide.

Section six: fees

Price per trip type, in the unit the payer uses, as set out in how to price NEMT services for a fair margin. Name that unit: a flat rate per trip, a rate per loaded mile, a rate by vehicle class — ambulatory, wheelchair or stretcher — and separate lines for no-shows and for wait time past the allowance. State the assumptions the price is built on: the load times you have assumed, the service area, and the volume mix.

State what changes the price and what triggers a re-quote. A fee with no stated assumptions is a fee you will be held to when the assumptions turn out to be wrong.

Section seven: what you need from them

Short and specific. Access information per site and who maintains it. A named contact for exceptions, and an after-hours arrangement if the service needs one. Timely notice of cancellations, referring back to the window in the scope. Whatever the payer requires them to provide.

Proposals rarely include this section and it prevents a great deal of trouble. Half of what goes wrong in a facility account is information that was never supplied.

Section eight: review

Name the interval, name what will be reported, and name who attends.

Track punctuality against the appointment time, exceptions by cause, and access problems. That turns the first review into evidence, not a talk about feelings.

Keep records that support both that review and the invoices. The Internal Revenue Service guidance on business records describes this as ordinary. Payer requirements add to it and vary by state, as the Centers for Medicare and Medicaid Services page on the benefit explains.

The template, section by section

Copy these lines and fill in the brackets. They are starting lines, not finished prose; the substance comes from your own operation.

One — what you understood. You told us [the problem, in your words]. You need [trip types] covered [days and hours] across [number] sites, and [the failure they described] resolved.

Two — capacity. We run [number] vehicles, [types], and can cover [number] trips on a normal day and [number] at peak, [days and hours]. If serving you fully needs [what you do not have yet], we can start [date].

Three — scope. We serve [ambulatory / wheelchair / stretcher] trips. Our days and hours are [days and hours]. Trips are booked [booking window] ahead. The driver waits [wait time] at the door before the trip is treated as a no-show, and cancellation notice is [window]. Our service area is [area]. We will not attempt a trip that needs [equipment or handling] not agreed here; we will contact [booking party] instead.

Four — how the service will run. Trips reach drivers by [assignment method]. Exceptions are handled by [named contact] and communicated by [method].

Five — evidence. Attached: [certificate of insurance], [authority and permit], [vehicle list], [training records], [procedures].

Six — fees. [Rate] per [unit]. Assumptions: [load time], [service area], [volume mix]. We will re-quote if [what changes].

Seven — what we need from you. Per site, [access information]; a named contact for exceptions, [name]; cancellations [window] ahead; [whatever the payer requires].

Eight — review. We meet [interval] and report [punctuality, exceptions by cause, access problems]. Attending: [names].

What the reader checks in each section

Sections two and seven are the ones that separate a proposal from a brochure, and they are the two most often left out.

What to be careful about writing

Describe the service in words you can meet on a bad day. Every assistance claim is an operational instruction to a driver, and describing what you offer accurately is the substance of the Federal Trade Commission's advertising guidance for small businesses.

Say nothing about what a program will cover. If the reader needs that answered, say that the payer decides and offer to help them ask. The wider approach to selling in this trade is set out in the sales and proposal guide.

Common questions

How long should the proposal be?

Short enough to be read in one sitting, with the evidence attached rather than included. The scope section can be as long as it needs to be; everything else should be tight.

Should I include references?

Only with permission and only where the referee has agreed to be called. A list of names nobody has asked is worse than none.

What if they have their own form?

Fill in their form and attach your scope section. Their form was almost certainly not written with wait rules and cancellation windows in mind.

Do I send a price before I have seen the sites?

No. Send the proposal with the price after the site visit, or send everything except section six and say when the fees will follow and why.