Understanding the NEMT Broker System: What You’re Really Signing Up For
By Rachel Scholler
Brokers are a major part of the NEMT landscape, but they’re often misunderstood— especially
by new providers. Here’s what you need to know:
- You Work for the Broker, Not Medicaid Even though Medicaid funds the ride, the
broker is your client. They set the rates, the rules, and the reimbursement timelines. - Rates Vary (and Are Often Non-Negotiable) Don’t expect to negotiate trip prices.
Know your operating costs and determine whether their rates work for you before
signing anything. - Payment Timelines Are Slower Than You Think Cash flow can be brutal. Some
brokers pay weekly, others monthly. And claims can be denied for the smallest clerical
error. Have a float. - Your Scorecard Matters Brokers track your on-time rate, complaint history, and
completed trip ratio. Too many issues, and you’ll lose access to better trips—or lose
the contract altogether. - They’re Not Your Only Option Broker work can be a good starting point, but it
doesn’t have to be your whole business. Consider private-pay clients, facility contracts,
or specialized transportation niches.
Understanding the broker system is critical to building a sustainable NEMT business. Don’t just
sign the contract—understand what it means for your margins, operations, and long- term
strategy.
Need help launching or growing your NEMT business? I offer consulting, SOP templates, and
hands-on support for providers across the country.
Email me at nemt.growth@gmail.com