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BadgerCare Plus>>Complaints and Fair Hearings>>

Wisconsin Medicaid and BadgerCare Plus

Complaints and Fair Hearings

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Please Note: The following information is about non-emergency medical transportation. If you have a medical emergency you should call 911.

Non-emergency medical transportation is a public transportation and shared ride service. Rides can include public transportation (such as a city bus), rides in specialized medical vehicles, or rides in other types of vehicles depending on your medical and transportation needs. If public transportation is not available, you will not be required to take it.

Medical Transportation Management, Inc. (MTM, Inc.), Wisconsin’s Medicaid and BadgerCare Plus transportation manager. MTM, Inc. schedules and pays for rides to Medicaid and BadgerCare Plus covered health care services.

Complaints

You or your chosen representative can make complaints about the service you received to MTM, Inc. Complaints may be about things like having a hard time getting a ride, long waiting times, or drivers who are late to pick you up. MTM, Inc. cannot help you with a problem until you file a complaint.

To file a complaint with MTM, Inc., you or your chosen representative can:

  • Call MTM, Inc’s “We Care” number at 1-866-436-0457.
  • Write to MTM, Inc. at the following address:

MTM Inc.
Quality Management
5117 W Terrace Drive
Suite 400
Madison, WI 53718

When filing a complaint, you must have your ForwardHealth ID number, name and date of service.

MTM, Inc. will mail you a response within 10 business days of receiving your complaint.

If you are not happy with how your complaint was resolved, your response letter will explain what next steps you can take.

Denied Transportation Services

If you were denied a transportation service by MTM, Inc. and you do not think it should have been denied, you have the right to appeal. For example, denials may include a denied ride or denied payment for meals or overnight stays.

To appeal a denied transportation service, you can either appeal to the MTM, Inc. Ombudsman or request a fair hearing directly from the Division of Hearings and Appeals.

Appealing to the MTM, Inc. Ombudsman is optional, but may be the fastest way to resolve your denial because you may be able to come to an agreement without having to wait for a fair hearing with the Division of Hearing and Appeals to take place.

Appeals with the MTM, Inc. Ombudsman

To appeal to the MTM, Inc. Ombudsman, you can:

  • Call the “We Care” number at 1-866-436-0457 and ask to file an appeal.
  • Or write to: MTM Inc.

Quality Management
5117 W Terrace Drive
Suite 400
Madison, WI 53718

If you request an appeal, MTM Inc. will send you a letter within 10 business days, even if the appeal is not resolved.

If the appeal is not resolved within 10 business days, MTM will send you a final letter after a decision has been made. The appeal process will not take more than 45 days.

If you are not satisfied with the decision of the MTM, Inc. Ombudsman, you can follow the continued appeal process described in the letter.

If you are still not satisfied, you may still request a fair hearing with the Division of Hearing and Appeals.

Fair Hearings

If you would like to request a fair hearing with the Division of Hearings and Appeals now, you must submit your request within 45 days of the date of your letter.

To request a fair hearing with the Division of Hearings and Appeals, complete the Request for Fair Hearing form and submit to:

Department of Administration
Division of Hearings and Appeals
PO Box 7875
Madison WI 53707-7875

You can get the Request for Fair Hearing form online at dhs.wi.gov/em/customerhelp or by calling (608) 266-3096.

You can also choose to write a letter to the Division of Hearings and Appeals in place of the form. Your letter should include the following:

  • Your name.
  • Your mailing address.
  • A brief description of the problem.
  • The name of the agency that took the action or denied the service.
  • Your social security number.
  • Your signature.

If you need help with asking for a fair hearing, please call 1-800-362-3002.

For more information

For more information about fair hearings, refer you your ForwardHealth Enrollment and Benefits handbook online at dhs.wi.gov/em/customerhelp or call 1-800-362-3002.

For more information about Scheduling Rides, Meals and Lodging, Complaints, New Rules:

P-00533D (07/13)

Go Back to Non-Emergency Medical Transportation Home Page

 

Last Revised: February 19, 2014