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Reliable Group

For non-emergency medical transportation brokers and providers

Trip cost and recoupments leak between booking and payment.

As your AI operating partner, we measure the reservations, closeout and claims work in a fixed-fee discovery, then rebuild and run it.

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Table of where cost, cash and risk sit in NEMT office work, by executive: service floors, trip spend, recoupments, will-call handoffs and audit exposure, each shown as worked by hand today and as rebuilt, from level of service matched to the contract's level of need form at booking to driver files matched to each trip date.
A pattern across NEMT broker and provider office work, not a client result.

Where the hours go

  • Capitated trip spend leaks at the booking screen.

    Brokers: ineligible members booked, wheelchair trips missing the contract's level of need form. Automation checks at booking; AI drafts trips from calls.

  • Ride status calls push hold times past service floors.

    Where's my ride calls swamp agents while will-calls wait. AI answers from provider trip status; stale status goes to an agent.

  • Denied claims, slow payment and recoupments start in trip logs.

    Unsigned logs, miles above mapped miles, lapsed driver files, encounter rejections. Automation matches logs to mapped miles, driver files to trip dates.

Medicare distribution, anonymized

Healthcare services

Commissions, HR and onboarding rebuilt while the business grew

A field marketing organization placing Medicare plans for 225,000+ lives through roughly 1,500 agents. Reliable Group rebuilt commissions, HR and onboarding around automation and AI, and gave agents a voice assistant for plan comparison and compliance. Sales capacity held and the business grew through the year, while the corporate team went from about 450 to under 200.

Grew, capacity held

One year: the business grew and sales capacity held. The corporate team went from about 450 to under 200.

anonymized realized

No NEMT engagement is published yet. This Medicare distribution case shows how we measure and run the work.

  • Growth and sales capacityanonymized realized

What transfers: Rules-driven back office queues rebuilt with automation first and people on exceptions, the pattern behind trip closeout, encounters and driver files.

See the measured results
Flow of one trip from booking to paid, showing where it waits on office work: four of five steps worked by hand today. Once rebuilt, automation runs gatekeeping, will-call relay and trip log review, AI answers status calls, and you keep the trip offer to providers.

What we do, and what we leave alone

Margin is lost between the booking and the paid trip.

A broker's margin lives in gatekeeping and cost per trip, a provider's in trips accepted, closed out and paid clean. Both lose it in handoffs: level of service, will-call relay, closeout, encounters, and the driver checks federal Medicaid NEMT rules require, as of 2026.

  • Routing and trip distribution stay yours
  • Drivers, fleet and capacity stay yours
  • Medical necessity stays with practitioners
  • Automation first, then AI, then people

Questions NEMT leaders ask

  • Two places. Office cost per trip, which the discovery measures in hours by workflow. Trip spend and recoupments: the discovery counts how often level of service errors, unsigned logs and miles above mapped miles occur, so you can price them. Tested, not promised.

  • We can flag them before payment. Automation matches each trip log, its pickup and drop-off times and signatures, to the booked appointment and the driver file to the trip date. A mismatch goes to a person; your program rules decide.

  • Both. A broker's week: reservations, standing order renewals, discharge requests, ride status calls, provider payment and encounters; reservations usually come first. Plans running a ride benefit start there too. A provider's week: trip intake, will-calls, closeout and broker claims; closeout and claims come first.

  • We usually work inside your scheduling system, broker portals and eligibility file, but routing, multi-load, trip distribution and driver capacity stay with your operations leaders. We rebuild the office work around them: will-call relay, provider acceptance follow-up, ride status calls and trip closeout.

  • No. Voice AI is a separate build, priced after the discovery. Trace measures desktop work; its microphone and system audio capture are off. The AI answers from provider trip status and GPS where shared; when status is stale or missing, the call goes to an agent.

  • Yes. Common floors in state broker contracts: on-time pickup, missed trips, complaints, speed of answer and abandonment, in some states with liquidated damages behind them. We write them into scope; a call the AI cannot answer goes to an agent and counts against the floor.

Sources for the rules and deadlines on this pagechecked November 1, 2026
  • Medicaid NEMT drivers must be off federal exclusion lists, hold a valid license and have driving history disclosed to the state, under Social Security Act section 1902(a)(87), added by the Consolidated Appropriations Act, 2021, and in force as of 2026. CMS, CMCS Informational Bulletin on Medicaid NEMT, July 12, 2021, checked November 1, 2026
  • State NEMT broker contracts set service floors for trip execution, scheduling, call answer times and incident reporting, with quarterly liquidated damages, in one state program as of 2025. Rhode Island EOHHS, NEMT dashboard, May 2025, checked November 1, 2026
  • Speed of answer, abandonment, substantiated complaints, late pickups and provider no-shows are reported monthly for a statewide NEMT broker, as of 2026. Wisconsin DHS, NEMT monthly report, May 2026, checked November 1, 2026
  • Trip logs carry pickup and drop-off times, odometer readings and member and driver signatures, and altered or incomplete logs can lead to denied claims and recoupments, in one state Medicaid NEMT program; rules vary by state. AHCCCS (Arizona Medicaid), NEMT daily trip report training, 2018, checked November 1, 2026

Rules change and vary by program, state and contract. Your compliance team confirms what applies to you.

How we handle regulated data

Design posture, not certification

Request documentation
BAA
Where a department handles protected health information, we execute a business associate agreement before Trace is installed or any data is accessed.
HIPAA
We execute a Business Associate Agreement before any engagement that touches PHI, and PHI is accessed only inside client-controlled systems by named individuals. Our first healthcare engagement under BAA is in progress.
Posture
Ready and aligned describe design posture, not certification. Reliable Group does not currently hold SOC 2 or ISO 27001 certification; our teams operate inside client-certified environments under client controls.
Notice
We deploy Trace only after your organization has given team members the written notice required in your state; we provide the notice template.

Your client-specific workflows, data and documentation are yours. Trace is Reliable Group software, licensed under the engagement; third-party tools keep their own license terms.

Last reviewed October 2026

Next step

Stop guessing how your operation works.

Tell us which department eats the most hours. We will say candidly whether measuring it is worth it.

Talk to usHow we start