How to Become an NEMT Broker

NEMT brokers are arguably the most important piece of the transportation puzzle. They schedule trips, coordinate with providers, and secure rides for people who need transportation to a healthcare visit. Brokers can be big or small, local or regional, or national, but they all do the same thing: find and schedule trips.

What Role Do Brokers Play in NEMT?

When a Medicaid beneficiary or healthcare facility needs to schedule a trip to an appointment, they call the broker’s office. The broker explains where the passenger needs to go, where the pickup spot is located, at what time the appointment is taking place, and what the NEMT van requirements are to match the passenger’s mobility situation. The broker is then responsible for verifying the Medicaid eligibility and, if cleared, scheduling and confirming the trip request.

At this point, it’s the broker’s job to get in contact with a provider that services the area where the trip was requested. Once a provider confirms, the broker can share the trip details with the customer. As you can see, there are a lot of different moving parts, and that’s just for one trip. Brokers deal with dozens of trip requests on a daily basis. Not only that, but they also help to see the trip through when it’s in progress and confirm that it was completed on time and at the correct location. As the need for NEMT continues to grow, there’s always a need for more brokers, especially those passionate about embracing new technologies to propel the industry. 

How Can You Become an NEMT Broker?

An NEMT brokerage is just like any other business. The process of starting it is quite straightforward yet full of unique hurdles. Let's discuss the major steps that must be taken by an entrepreneur seeking to enter this field.

Scout the Field: Evaluate the Demand for NEMT Services

The very first piece of advice you would hear from any business coach is to make sure that the demand for your future enterprise is present. It doesn’t make sense to invest your time and money into a business that wouldn’t have any customers or if it is fully monopolized by large players that operate across the nation. Evaluate the NEMT business potential by talking to the future competitors, NEMT providers, healthcare facilities, and current or potential service users.

You can educate yourself about the current state and growth prospects for the NEMT niche in your area with the following strategies:

• Analyze the local demographics, focusing on populations likely to need medical transportation (e.g., seniors, disabled individuals, and low-income communities).
• Review Medicaid enrollment numbers.
• Assess the current NEMT brokering landscape, identifying service gaps.

Devise a Solid Business Plan

Going blind is a recipe for disaster. Consider drafting a solid business plan for the first 12-24 months of operation. You should evaluate whether your initial investment and projected earnings will be sufficient to cover your business expenses. Will you be able to reach the break-even point with your own money, or should you consider financing? Account for startup costs (initial licensing, hardware) and ongoing expenses (salaries, marketing, software, insurance). Be ready for a slow start and always maintain a budget for unexpected expenses like hardware breakdowns, additional training, new marketing campaigns, etc.

Optional Step: Obtain Necessary Training and Experience

Surely, you can jump into the world of NEMT brokering right away, but this trade is not that simple and requires quite a lot of skills. It might be smart to start out not as an independent contractor but rather get training and experience by working for established businesses.To learn the ropes of routing, scheduling, and billing, you can start as an employee at a brokerage or transition from related positions, such as a dispatcher or NEMT driver. It is vital to learn about the channels how NEMT brokers get paid and know the rates to engage in reasonable price negotiation with future partners.

Get Licensed and Insured

Unlike non-emergency medical transportation providers, in the majority of cases, brokers do not need a long list of licenses and certifications. However, there are some requirements that cannot be avoided.

Registration: Most brokers will need a standard business license to operate legally in their area. You will have to be registered as a sole proprietor or a legal entity (LLC, corporation) to obtain an EIN, state tax ID, hire employees, and open bank accounts.

Medicaid enrollment: The broker working with Medicaid clients or other government-funded programs may need to obtain additional registration with these entities and submit to audits. We have to be honest with you; bigger organizations like Modivcare and MTM often dominate such contracts. However, there is no reason to deny your growing business an opportunity to compete for such contracts. After all, these national brokers also started small in the 1990s.

Insurance requirements: Depending on your jurisdiction, to work as a broker, one might need to be covered by commercial general liability insurance, professional liability/errors & omissions coverage, and workers' compensation insurance.

Start Building Provider and Client Databases

The best way to start your journey to becoming an NEMT broker is by solidifying relationships with those in the industry. It’s good to start local, but there’s nothing wrong with also reaching out to state and federal agencies. It’s also a good idea to contact hospitals and doctor’s offices who may need help transporting patients to medical appointments at their facilities. Get in touch with any NEMT providers you know of to see if they’re looking for new broker partners. You can also attempt to seek out private passengers by going door-to-door, but it is recommended to use more efficient marketing channels like social media and local advertising.

Essentially, any connections you can make right off the bat will give you a leg up. Once you’ve formed some solid broker-partner relationships, keep a database of all your contacts and make sure they have your information, too. And last, but definitely not least, look into an NEMT software platform that will make doing your job simpler and more efficient. The best software on the market offers NEMT broker integration, so everyone can easily communicate and stay connected in order to perform the best service possible.

Broker Your First Trips and Never Look Back

Once the above steps are taken, it is time to broker your first medical transportation trip. Your journey is just beginning, so do not hesitate to start small to build your reputation. You might want to consider taking smaller commissions and working with less “lucrative” orders in an attempt to outbid well-established players.

To succeed as an NEMT broker, it's essential to stay proactive and build strong, lasting broker-partner relationships with all parties involved—clients, providers, and healthcare facilities. Keep track of credentialing to prevent fraud, confirm that passengers are eligible for the NEMT service, and ensure that all partners are up-to-date and compliant with regulatory requirements. As the NEMT industry grows, it's important to stay ahead of the game by analyzing data to improve services, identify trends, and make smarter decisions. Regularly reviewing performance metrics will help you fine-tune operations for efficiency and better customer service. Additionally, continuous marketing and advertising efforts will keep your services visible and attract new clients, ensuring your business keeps growing.

With the right strategies and tools, like broker-oriented NEMT software, you can thrive in an ever-expanding industry. If you’re interested in exploring new RouteGenie capabilities, reach out to our experts today to learn more!