a. Agreement – The transportation agreement of which this Manual is an integral part.
b. Bariatric – Either a passenger whose weight is over 300 lbs.; a wheelchair with a wheel base wider than 32 inches; or a combined passenger/wheelchair of 800 lbs. or over.
c. Contracting Entity – The organization that Veyo contracts with to provide transportation services.
d. Door-to-Door – Service where the driver escorts or ensures visually that the passenger gets between the door of the residence or medical facility and the door of the vehicle.
e. Hand-to-Hand – See Person-to-Person.
f. NEMT/NET – Non-Emergency Medical Transportation/Non-Emergency Transportation.
g. Network – The body of transportation providers contracted to provide services on behalf of Veyo.
h. Passenger – An individual recipient of transportation service provided on behalf of the Contracting Entity.
i. Person-to-Person – Service where the driver must get acknowledgement from another person at both the pick-up and drop off. At pick up, the acknowledgement is that the passenger is going with the driver and at drop-off, that a responsible person is at the location.
j. Reward – An additional fee allocated to a transport above the standard contracted rate.
k. Service Area – The geographic area that the Provider has indicated that they service.
l. Transportation Provider – A public, private, or volunteer entity providing transportation services on behalf of Veyo.
m. Trip – Transportation of a passenger from pick-up to a destination location.
n. Trip Failure – A missed, late, or otherwise improperly executed trip which requires rescheduling of the passenger’s appointment.
2. Veyo Overview
a. Veyo is a transportation management company which contracts with both private and public agencies to provide fully outsourced, turnkey mobility management services on behalf of the Contracting Entity.
b. Veyo provides Transportation Providers with outsourced call center service, automated trip dispatch service, and other backroom support services designed to improve the quality, efficiency, and cost effectiveness of Provider operations.
3. Responsibilities of Veyo LLC
a. Processing Transportation Requests. Veyo will receive transportation requests from Passengers or their agents, verify Passenger eligibility, schedule reservations, offer trips to the Provider, verify billing information, and perform such other administrative functions as Veyo deems necessary. Any trip request assigned to Provider may be withdrawn by Veyo, in its sole and absolute discretion, in the event that Veyo deems such withdrawal necessary for the proper performance of its obligations to the Contracting Entity.
b. Veyo will assign all trips to Provider via a designated portal. Additionally, all Provider reimbursement processes will be managed utilizing the portal.
c. Payments for Transportation. Subject to Provider’s compliance with the terms of the Agreement and the this Manual, Veyo will pay Provider for its services at the rates and on the terms that have been established, subject to such offset or withholdings as are permitted or required under the Agreement. Provider will not invoice or require payment from Passengers or Contracting Entity for such services, except for collection of applicable co-payments, or as authorized by the Contracting Entity.
d. Orientation. Veyo will provide one or more orientation sessions for Provider staff, which will be offered at a Veyo regional office or Provider’s base of operations. Provider is responsible for ensuring that its employees understand all requirements and procedures for the provision of services pursuant to the Agreement.
e. Minimum Trips. Provider agrees that the Agreement does not guarantee a minimum number of trips to be offered from Veyo, and that actual trip volume can vary. If Provider is not regularly offered trips and wishes to terminate the Agreement, then Provider must terminate the Agreement in accordance with section 8 of that Agreement.
f. Credentialing and Re-Credentialing.
- Veyo will conduct an initial Credentialing review, in person, where all company files, driver files, and vehicle files will be reviewed.
- Veyo will conduct annual credentialing reviews thereafter.
4. Responsibilities of Provider
a. Provider will comply with each of the following Provider accountabilities described below in subsections a) through l), as well as employee driver and/or independent contractor, driver recruitment, training, and operational policies and procedures.
b. Administrative, Reservation Receipt, and General
- Provider will comply with applicable city, county, state, and federal requirements regarding licensing, certification, and insurance for all personnel and vehicles.
- Provider will utilize only drivers and vehicles that meet all the qualifications required to perform services under the Agreement, as set forth in the credentialing checklists.
- Provider will ensure the safety of the Passengers that it transports.
- Provider will, as required, provide additional levels of service, e.g. door-to-door, hand-to-hand.
- Provider will notify Veyo the next business day if the passenger’s contact number(s) are disconnected or incorrect.
- Provider will transport Passengers and transportation attendants as applicable and in accordance with the specifications of the reservations provided by Veyo and the terms of the Agreement.
- Provider, upon consultation with Veyo, may refuse to transport any person who, in the judgment of Provider, is a threat to the health, safety, or welfare of Provider’s employees or other Passengers, or prevents or inhibits the vehicle from being operated in a safe manner.
- Provider will ensure that all information obtained regarding Passengers in connection with this Agreement is held in strict confidence and is used only as required in the performance of Provider’s obligations.
- Provider will give “will call” receipts that provides Passenger with information on how to arrange for their return trip.
- Provider will keep logs documenting the date, time and telephone number for each call made to passengers regarding transportation.
- Provider will ensure all staff new-hire and annual training on FWA “Fraud, Waste and Abuse”.
- Provider will establish and maintain a telephone line, internet access and the ability to accept fax/electronic transmissions.
- Provider will receive trip reservations via fax from Veyo anytime that the designated portal becomes unavailable. Provider will confirm the receipt of all faxes in a form acceptable to Veyo.
- For same-day or urgent medical appointments, including hospital discharges, Provider will accept reservations and confirmation numbers from Veyo by telephone.
- Provider will return any future trip assignments previously accepted by 5:00PM Mountain Time. In the event that Provider does not return trips by 5:00PM Mountain Time and Veyo must make alternate transportation arrangements, Provider will be responsible for any additional charges incurred. These charges may be deducted from amounts owed to Provider. This provision may be waived at the sole discretion of Veyo under circumstances deemed out of the control of Provider by Veyo (e.g., sudden vehicle breakdown or vehicle accident).
- Provider will promptly inform Veyo if a Passenger is assigned to an improper level of service (e.g., an ambulatory patient assigned to a wheelchair trip or a wheelchair-bound patient assigned to an ambulatory trip).
- Provider will report any suspected Fraud, Waste and Abuse to Veyo.
- Provider will, with seventy-two (72) hours’ notice, fully support Veyo’s credentialing, recredentialing activities, and/or any other credentialing reviews by providing any requested company, driver and vehicles files and making vehicles available for physical inspection.
- Provider will train drivers in all requirements of the contract (detailed in Company Credentialing Checklist).
c. Pick-up and Delivery Standards.
- Provider will provide transportation services that comply with the following minimum service standards. The staff of Veyo or Contracting Entity, or their official agent, may ride on trips with any Passenger at any time to monitor service.
- Providers are expected to provide “on time” performance at all times. Transportation services must be performed within the following parameters to be considered “on time.”
- For scheduled, “on time” is defined as within thirty (30) minutes of the scheduled time.
- For “will call” trips, “on time” is defined as within sixty (60) minutes of notifying the Provider.
- The driver will make his/her presence known to Passenger upon arrival at the pick-up address by providing their name and company.
- Drivers shall provide the Passenger with boarding assistance, if necessary or requested, to the seating portion of the vehicle. The boarding assistance will include, but not be limited to, opening the vehicle door, utilization of wheel chair securement devices, storage of mobility assistance devices and closing the vehicle door. In the door-through-door paratransit service category, the driver shall open and close doors to buildings, except in situations in which assistance in opening and/or closing building doors would not be safe for passengers remaining in the vehicle. The driver will provide assisted access in a dignified manner. Drivers may not assist wheelchair passengers up or down more than one (1) step, unless it can be performed safely as determined by the passenger, guardian, and driver.
- The driver will wait at least five (5) minutes after the scheduled pick-up time before Passenger may be considered a “no show.” If Passenger is not present for pick-up, the driver will notify Provider’s dispatcher before leaving the pick- up location.
- Hospital discharges will be picked up within three (3) hours of the provider being notified and provider will notify Veyo if they expect any delay.
- Some providers will be required to obtain, during the trip, signatures from the passenger and/or attendant as a means to verify and validate that transportation was provided. A separate signature will be required for each leg of a trip. In the event a signature is not able to be obtained the provider will document the circumstances to report back to Veyo, at no time will service be denied. This requirement will only be required if stated in Exhibit “D” of the Transportation Provider Agreement.
- If a delay of fifteen (15) minutes or more occurs in the course of picking up scheduled riders, Provider must contact waiting Passengers to inform them of the delay and the expected arrival time of the vehicle.
- Provider must advise scheduled riders of alternate pick-up arrangements when appropriate (e.g. Vehicle substitution).
- If a Provider-caused delay occurs that results in a Passenger being late for a medical appointment, Provider must immediately notify Passenger’s medical provider of the delay. If the delay requires Passenger to reschedule their medical appointment, Veyo must be notified immediately and Provider will be expected to provide Passenger’s transportation to the rescheduled appointment at no additional cost to Veyo.
- Passengers who are 12 years of age or younger will be transported in accordance with State law and the contract.
- Passengers 13 years or older, but younger than 18 years of age will be transported in accordance with the Agreement.
- A minor Passenger will be transported in the rear seat or compartment of the vehicle and will not be permitted to travel as a front-seat passenger.
- A transportation attendant or personal assistant may ride with a Passenger, at no additional charge, if necessary to assist Passenger.
- Provider must allow service animals in the vehicle as needed and required by law; however, other animals will not be allowed onboard the vehicle.
- When transporting an individual on a stretcher bed-to-bed service is required.
d. Driver Qualifications
- All drivers used to perform services under this Agreement will meet the qualifications specified in the Credentialing Checklist.
- Drivers must be able to speak and understand English.
- The records and qualifications for each driver and attendant are subject to an initial and annual inspection by Veyo, as well as interim inspections as required at the sole and absolute discretion of Veyo.
- Any driver or attendant failing, at any time, to meet all of the applicable qualifications, or any requirements imposed by state or local law, will be prohibited from providing service under this Agreement. Veyo and Contracting Entity reserve the right to disallow any driver or attendant from performing services under this Agreement.
- No driver will use any substance (alcohol, over-the-counter medication, prescription medication, narcotics, or illegal drugs) that impair his/her ability to perform while on duty, or abuse alcohol or drugs at any time.
- A driver or attendant can use prescribed medication as long as his/her duties can still be performed in a safe manner and Provider has written documentation from a physician or pharmacist that the medication will not impact the ability of the driver.
- No drivers will allow firearms, alcoholic beverages in opened containers, unauthorized controlled substances, or highly combustible materials to be transported in the vehicle.
- No drivers will solicit or accept controlled substances, alcohol, or medications from Passengers.
- No drivers will make sexually explicit comments, or solicit sexual favors, or engage in sexual activity while in the course of their job duties.
- Drivers will not be required to drive when their ability is impaired, they are fatigued, ill or for any other reason that would cause unsafe driving.
- No drivers will solicit or accept money from Passengers, except for the collection of applicable co-payments, or as authorized by Contracting Entity.
- All drivers will provide an appropriate level of assistance to a Passenger when requested or when required by Passenger’s physical condition.
- No drivers will smoke while in the vehicle, while assisting a Passenger, or in the presence of any Passenger. Passengers will not be allowed to smoke in the vehicle.
- No drivers will wear any type of headphone while on duty, with the exception of hands-free headsets for cell phones. Cell phones may only be used in performance of services under the Agreement, and driver will at all times comply with applicable laws regarding the use of cell phones by the driver of a moving vehicle.
- All drivers will park the vehicle so that Passenger does not have to cross streets to reach the entrance of the destination.
- No drivers will leave a Passenger unattended for more than five (5) minutes.
- All drivers will ensure that any packages are safely stored before the driver moves the vehicle. Drivers and/or attendants are not responsible for Passengers’ personal items.
- All drivers will be courteous, patient, and helpful to all Passengers and be neat and clean in appearance.
- If the behavior of a Passenger or other passenger or any other condition impedes the safe operation of the vehicle, the driver will park the vehicle in a safe location out of traffic, notify Provider, and request assistance.
- The provider will require all drivers to conduct a vehicle safety check each day and must include the following checks.
- The driver will operate the vehicle in compliance with applicable traffic regulations, ordinances, and laws of the jurisdiction in which they are being operated.
- Drivers will not operate any vehicle while the doors are open (starting, in transit, stopping).
- Driver will wear their seat belt at all times while operating the vehicle and will encourage passengers to wear theirs.
- Driver will set the parking break and leave the vehicle in a safe condition any time an unattended passenger is in the vehicle.
e. General Vehicle Requirements.
- All vehicles utilized by Provider in the performance of services under this Agreement must meet the requirements highlighted below and specified in the Credentialing Checklist. Each vehicle is subject to an initial and annual inspection by Veyo. This may be waived, at Veyo’s sole discretion, if the vehicle is otherwise routinely inspected by a governmental agency.
- All vehicles must be made available to Contracting Entity or its agent(s) for inspection with seventy-two (72) hours’ notice.
- Inspections performed by Veyo do not replace or excuse Provider from obtaining vehicle safety inspections as required by State or local law.
- Any vehicle found non-compliant with the inspection standards, Federal, State, or Local licensing requirements, vehicle safety standards, Americans with Disabilities Act (ADA) regulations, or other state or federal laws or regulations will be immediately removed from providing service under this Agreement and will pass a re-inspection before it may be used to provide further services.
- The number of occupants in the vehicle, including the driver, will not exceed the vehicle manufacturer’s approved seating capacity.
- Vehicles should not be refueled in a closed building and the number of times a vehicle is refueled when passengers are onboard should be minimized.
f. Wheelchair-Accessible Minivan Requirements.
- A “wheelchair-accessible minivan” is described as a standard passenger van converted to accommodate side-or rear-loading of wheelchair-bound passengers via a pull-out or fold-out ramp. All such vehicles used to transport wheelchair passengers must meet the “General Vehicle Requirements” set forth above as well as the additional requirements specified in the Credentialing Checklist.
- Installation of a wheelchair ramp or lift will not cause the vehicle to exceed manufactures GVWR, gross axle weight or tire rating.
- Proper procedure of ramp/lift instructions will be kept on vehicle at all times.
g. Wheelchair Vehicle Requirements. A “wheelchair vehicle” is a full-sized multi- passenger or cargo van converted to accommodate side or rear-loading of one or more wheelchair-bound passengers utilizing hydraulic (manual or electric) or electromechanical lifts. All such vehicles used to transport wheelchair passengers must meet the “General Vehicle Requirements” set forth above as well as the additional requirements specified in the Credentialing Checklist.
h. Stretcher Vehicle Requirements.
- Stretcher van service is an alternate mode of non-emergency transportation. It will be provided to an individual who cannot be transported in a sedan, wheelchair-accessible minivan, or wheelchair van, and who does not need the medical services of an ambulance. All stretcher vehicles must meet the “General Vehicle Requirements” set forth above as well as the additional requirements specified in the Credentialing Checklist.
- Unless the manufacturer of the equipment states in its specification sheet that the equipment may be operated by one operator, a driver and an attendant operator will staff the vehicle, which will be specifically designed and equipped to provide non-emergency transportation of individuals on an approved stretcher.
- A stretcher passenger will not be left unattended at any time.
- The driver and attendant, if one is required, will confirm that all restraining straps are fastened properly and that the stretcher, stretcher fasteners, and anchorages are properly secured.
- The attendant, if one is required, will be seated in the passenger compartment while the vehicle is in motion and will notify the driver of any sudden change in the passenger’s condition.
- The stretcher vehicle will not be used:
1. For emergency medical transportation.
2. To transport a passenger who requires basic or advanced life support.
3. To transport a passenger who has in place any temporary invasive device equipment, such as an intravenous administration device, an airway maintenance device, or any medical device which might require administration during transport.
4. To transport a passenger who requires close observation or medical monitoring.
i. Non-Emergency Ambulance Vehicle Requirements.
- All vehicles used to transport Passengers that require covered non-emergency basic life support (BLS) or advanced live support (ALS) service must meet the “General Vehicle Requirements” set forth above as well as the additional requirements specified in the Credentialing Checklist.
j. Maintenance of Records.
- To support credentialing and re-credentialing, Provider will create and maintain driver, vehicle, trip and other records as detailed in the agreement and provide copies thereof within three (3) days’ notice from Veyo, the Contracting Entity, or their agents.
1. Credentialing is detailed under paragraph 3.e.
- All credentialing and recredentialing checklists, detailed vehicle maintenance records, investigations on grievances and complaints, and corrective action plans will be maintained for 5 years.
- Investigation reports, corrective action plans, and related supporting documentation for any event involving a vehicle and resulting in a fatality, injury or property damage. (Five years from the date of completion of the investigation.)
- All records will be maintained and available for review by authorized personnel during the entire term of the contract and then in accordance with Federal, State and Local regulations.
- If a credentialing review is in progress or litigation is in progress or threatened, all documents will be maintained until such credentialing review and/or litigation is fully resolved.
- In compliance with 42 CFR § 1001.1301, IDHW, the Medicaid Fraud Control Unit of the office of the Idaho Attorney General, the U.S. Department of Health and Human Services, or their agents, shall be given immediate access to, and permitted to review and copy any and all records relied on by the Provider in support of services billed to Medicaid.
k. Provider Performance Standards/Quality Assurance Plan. Provider agrees to participate in Veyo’s quality assurance plan, which may include discussing Provider’s performance in the delivery of transportation. Provider agrees to assist in the development of corrective action plans and cooperate with all data collection that may be requested to monitor the results of such corrective action plans.
l. Accident/Incident requirements:
- In the event of a passenger medical emergency:
a. If the incident requires immediate medical assistance, the drivers should call 911 first and then call their company dispatch.
b. Required Reporting Information
- Detailed description of emergency
- Name of Passenger
- Description of any injuries
- Location of incident
- Any other pertinent details that first responders may need.
2. Transportation Provider Dispatch
a. Determine if the driver called 911 themselves or if the provider’s dispatch personnel need to call 911 on behalf of the driver.
b. Call 911 as needed.
c. Determine if a rescue vehicle is required and send as needed.
d. Document all the information provided by the driver and notify the Veyo Staff.
3. Veyo must be notified within 1 hour if a passenger is injured.
4. Veyo will notify the Contracting Entity.
- In the event of an accident during transportation:
a. If there are resulting injuries that require immediate medical assistance, the drivers should call 911 first and then call their company dispatch.
b. If there are not injuries, the driver should contact their company dispatch.
c. Required Reporting Information
i. Detailed description of emergency
ii. Name of Passenger(s)
iii. Description of any injuries
iv. Location of incident
v. Any other pertinent details that first responders may need
2. Transportation Provider Dispatch
a. Determine if the driver called 911 themselves or if the provider’s dispatch personnel need to call 911 on behalf of the driver
b. Call 911 as needed
c. Send a backup vehicle to transport passenger(s) to their destination
d. Determine if a rescue vehicle is required and send as needed
e. If the transportation provider is unable to transport the participants, immediately notify Veyo
f. Document all the information provided by the driver and notify Veyo.
g. Veyo will notify the Contracting Entity as appropriate.
- Liability for any personal injuries and/or property damage that occur as result of an accident are the sole responsibility of the Transportation Provider and not Veyo or the Contracting Entity.
- The Provider will provide a written report to Veyo within three (3) working days of the accident/incident and will cooperate with Veyo and Contracting Entity during an ensuing investigation. Provider will include a copy of any police reports and tickets/summons with its written report as supporting documentation.
- The Provider will complete a full investigation as soon as practical on any accident/incident that could result in liability to Provider or Veyo and communicate their findings regarding liability to the Passenger, Veyo, and their insurance provider as appropriate. This report will include:
1. A description of the investigation;
2. Identified causal factors; and
3. Corrective actions.
- In addition to these general requirements for all accidents/incidents; the provider must assist Veyo in reporting to the Contracting Entity:
1. A fatality where an individual is confirmed dead, within three days of a Transportation services related event
2. A detailed report with the Agency within ten days of the event
3. Injuries requiring medical attention away from the scene for two (2) or more individuals
4. Property damage totaling more than one thousand dollars ($1000.00)
m. Transportation Provider Complaint:
- When a transportation provider has an issue or complaint with the Agreement they must make that complaint in writing to Veyo.
- The complaint must clearly state:
- A detailed explanation of the issue.
- Actions that the provider has taken to mitigate the situation.
- Others with knowledge of/information regarding the issue.
- Others with an interest in the issue.
- Proposed solution or desired remedy.
- The complaint should be made to the Transportation Management or account staff.
- Veyo will investigate the complaint and respond to the transportation provider, within 10 business days.
n. Complaints against the Transportation Provider:
- When Veyo receives a complaint on the services provided by a Transportation Provider they will collect all pertinent information. This will include the time and date of the incident, the vehicle number, the driver name if available – as well as a detailed description of the incident. The complaint will be categorized based on a series of topic areas for reporting purposes.
- The complaint will be forwarded to the Provider.
- The Transportation Provider will have three (3) business days to investigate and respond to the complaint. The response will include as much detailed information as available to address the complaint. This information will include verification of the vehicle identification number, driver name, and trip related information. In addition the response will either,
- Validate the complaint as true,
- Dispute some or all of the complaint, or
- Deny responsibility for the complaint as the trip was not performed by the Transportation Provider. vii. In the case of either b) or c), the Transportation Provider will be responsible for providing refuting information and documentation to justify their assertion. This documentation must be verifiable in order for the complaint to be deemed unjustified and closed.
- Upon receipt of the information, Veyo will make a determination as to the validity of the complaint and confirm that finding with the Contracting Entity. Once a final decision has been reached Veyo will:
- Respond to the passenger within two (2) business days and will confirm Veyo’s findings. If the client disputes this finding, the matter will automatically be referred to the General Manager. The General Manager will discuss the situation with the passenger, review all the available information and provide a final determination.
- Consult with the Transportation Network staff and inform the Transportation Provider of the findings. If the Transportation Provider may choose to accept or appeal the decision to the General Manager.
o. Complaint Log. Veyo will maintain a log of all complaints and records of all investigations.
5. Trip Distribution
a. Trip Distribution. Two Automated distribution methodologies will be used in combination with the use of “special assignments” to distribute all trips. The two methodologies include Standard Assignment and Exclusive Assignment.
- Standard Assignment. Providers with standard ratings will automatically be assigned all trips in their designated service territory (ST). Trips will be assigned by cutoff times of 2:00 pm. Any trips that Provider cannot accommodate will be returned to Veyo no later than 8:00 pm on the day the trips were assigned.
- Special Assignment. Emergencies and other special circumstances will sometimes require the independent negotiation of “special assignments.” Special assignments will only be utilized when the two (2) automated distribution methods are unable to accommodate the trip requirements.
1. A “surcharge” must be negotiated and approved prior to performing any special assignment. Surcharges will be invoiced and paid separately from the standard trip payment.
b. Service Delivery Management
- The service delivery process is responsible for the successful management, coordination, and execution of defined transportation solutions.
- Service delivery management consists of the following functions.
1. Trip Receipt Confirmation. Once a trip has been successfully distributed to a Provider, it will be posted to Provider’s “Service Delivery Screen.” Providers will use the “Service Delivery Screen” to confirm receipt of all trips. The “Trip Receipt Confirmation” serves as the formal acknowledgement of Provider’s receipt of the trip request as well as their commitment to perform the services required to properly execute the transport.
2. Trip Reroute. Providers are expected to accept and complete all trips received through the trip distribution methods described previously. However, in the event a Provider is unable to meet this expectation, Provider will be allowed to “reroute” trips under the same penalty as a trip failure. As with any trip failure, rerouted trips will have a serious adverse effect on Provider’s performance rating and could jeopardize Provider rating.
3. Trip Resolution. Upon resolution of an assigned trip, Provider must provide the resolution data required to successfully close out the trip in the transportation portal and qualify the trip for payment.
- Trips can be resolved in any of the following manners.
1. Completed Trip. Upon successfully completing a trip, Provider is required to enter the pick-up and drop-off times in the transportation portal in order to close out the trip. On “will call” returns, Providers are also required to enter the time the passenger placed the request for the return pick-up.
2. Canceled Trip. A trip can only be canceled by an authorized Veyo representative at the request of the passenger or paying passenger. Veyo agents are required to enter cancellations into the transportation portal immediately upon receipt. If a cancellation occurs to the scheduled trip, the Veyo agent will notify the transportation service Provider via telephone in addition to cancelling the trip in the transportation portal.
3. Void Trip. When a driver is unable to pick up a passenger due to no fault of their own, the trip is considered “void.” Transportation service Providers are required to notify Veyo immediately upon learning of a void trip. Upon completion of the telephone notification, Providers are required to enter the time and reason for the void and close out the trip in the transportation portal.
c. Exception Processing
- Service exceptions may occur from time to time that require review and approval of requests for modified payments. Negotiable exceptions are limited to the following:
1. Necessary mileage differences in excess of ten (10) percent; and
2. Delays in excess of fifteen (15) minutes.
- Providers will submit exception requests through the transportation portal prior to closing out the trip. Exceptions will not be accepted after a trip has been closed out. Providers will be paid the amount of the original trip request as part of the normal account reconciliation process. Exceptions will be paid separately following review and adjudication of the request.