Mileage Reimbursement Process
Reimbursement is available per mile. To qualify for reimbursement, members can call ModivCare, Alivi or MTM Monday through Friday between 8 a.m. and 5 p.m. Eastern up to 30 days in advance but no later than the day of the appointment. Back dated mileage reimbursements are not allowed.
When a member calls for a reservation, the member should provide ModivCare, Alivi or MTM with the name and mailing address of the person to whom the reimbursement is to be made payable. Once the trip is verified, the member will be issued a Reference Number. This Reference Number becomes the member’s Mileage Reimbursement Trip/Job number. Members will only be reimbursed for trips on their Mileage Reimbursement Trip Log that includes this number.
Members, spouses or parents/guardians cannot get gas mileage reimbursement.
Mileage Reimbursement Trip Logs for Medicaid, Serious Mental Illness and Child Welfare members should be mailed to ModivCare for payment at:
ModivCare Claims Department
Mileage Reimbursement
798 Park Ave. NW
Norton, VA 24273
Mileage logs for Long Term Care members should be mailed to Alivi for payment at:
Alivi Claims Department
7205 Corporate Center Drive, Suite 404
Miami, FL 33126
Mileage logs for CMS Health Plan members should be mailed to MTM for payment at:
MTM Attention: Trip Logs
16 Hawk Ridge Drive
Lake St. Louis, MO 63367
Each log must be filled out completely to qualify for reimbursement, including a trip date, medical provider name and phone number, physician/clinician signature, and total number of miles driven associated with that particular visit. Each date of service must have a physician or clinician signature.
Plan Type | Mileage Reimbursement Phone Number |
---|---|
Medicaid | 1-877-659-8420 (TTY 1-866-288-3133) |
Child Welfare | 1-877-659-8420 (TTY 1-866-288-3133) |
Serious Mental Illness | 1-877-659-8412 (TTY 1-866-288-3133) |
Long Term Care | 1-877-659-8414 (TTY 711) |
CMS Health Plan | 1-888-513-0703 (TTY 711) |