NEMT Experts Podcast Episode 5: How to Negotiate with your NEMT Broker

Bambi CEO Nirav Chheda interviews NEMT expert Matt Murphy on how to negotiate with your NEMT broker. Matt was a co-founder of Circulation (tech-enable broker acquired by Modivcare) and former VP at Modivcare, the largest NEMT broker company.

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See the full interview at: https://youtu.be/0sAUYpnKgGY

Please don't forget to subscribe and like NEMT Experts Podcast: https://www.youtube.com/@bambihealth

Podcast Show Notes:

Key Takeaways

• 1. Preparation
  • Understand your costs: Analyze all costs associated with running your NEMT company (insurance, labor, fuel, vehicle costs, etc.). This is absolutely foundational to profitable negotiation.
  • Know the market: Identify trip characteristics in your market (distance, urban/rural density, locations of major medical centers). Understand your local or regional broker's knowledge of these details.
  • Assess the competition: How many other NEMT companies are competing for the same contracts as you? How does this factor into bargaining power?
  2. Negotiation
  • Stage your approach: Don't try to negotiate everything at once. Focus the first meeting on understanding the broker's needs, trip volume, and typical trip characteristics. Don't discuss rates initially.
  • Inside vs. Outside the contract: Understand what can be formally negotiated (rates, SLAs) vs. what can only be informally agreed upon (desired trip types).
  • Where to compromise: Negotiate the rates most important to you, and be willing to cede on less-profitable trip types if you have the leverage to do so.
  • Avoid frequent re-negotiations: Set your rates correctly the first time. Re-negotiations within the first year may make you seem unprofessional or unreliable. Annual reviews or re-negotiations prompted by major market changes in your cost structure are appropriate.
  3. Post-Negotiation Launch
  • Software is key: Utilize software to track your trip types and compare them to your negotiated targets.
  • Be the squeaky wheel: Stay in close contact with your broker's dispatchers to ensure you receive the agreed-upon mix of trips.
  • Hold the broker accountable: Review your trip volume data monthly with the Regional Operations Manager to ensure promises are being kept.

Important Quotes

• "Know how much it costs for you to do business and bring that into every negotiation with your broker." – Matt Murphy
• The biggest reason I see transportation providers fail...is they don't understand the cost structure, and they don't have a good accountant." – Matt Murphy
• "Be aggressive but polite and continue to call the broker day after day." – Matt Murphy

Here are some time-stamped show notes:

00:00 Introduction

‍01:18 Preparing to negotiate

‍05:18 Actually negotiating

‍11:03 Launching after negotiating

‍13:35 Conclusion

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Keep it Simple in NEMT

At Bambi, we pride ourselves on keeping our software simple and easy to use. To streamline operations, NEMT companies need advanced scheduling and dispatch software that not only offers powerful features but also requires minimal training to use effectively. Bambi has gained a reputation for its user-friendly design and simplicity, making it an excellent full-suite NEMT scheduling and dispatch platform for both new and experienced users.

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User Friendly Design

One of the standout features of Bambi NEMT Scheduling and Dispatch Software is its user-friendly design. From the moment you see Bambi’s software, it’s clear that we prioritized ease of use when building out every part of it. Here are some key aspects that contribute to its user-friendliness:

1. Intuitive Interface: Bambi's interface is clean, organized, and easy to navigate. Users can quickly access the features they need without feeling overwhelmed by unnecessary clutter.

2. Minimal Learning Curve: The software is designed to be straightforward and requires minimal training. NEMT providers can get started quickly, reducing downtime and ensuring that staff can focus on their core responsibilities.

3. Visual Scheduling: Bambi uses visual scheduling tools that make it easy to create and manage transportation schedules. Users can view all appointment on an intuitive calendar screen, assign vehicles, and view routes on a map with ease.

4. Clear Dashboard: The dashboard provides a snapshot of the day's activities, including pending bookings, completed trips, and any potential issues. This at-a-glance view allows dispatchers to stay on top of operations without digging through layers of menus.

5. Streamlined Booking Process: Bambi simplifies the booking process, allowing staff to enter trip details, patient information, and other essential data in a matter of minutes. This efficiency ensures that patients receive timely service.

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Minimal Training Requirements

Bambi's user-friendly design goes hand in hand with its minimal training requirements. Here's why NEMT providers find it easy to get their staff up to speed with the software:

1. Dedicated Support: The Bambi team provides excellent customer support, offering assistance and guidance when needed. This level of support can be invaluable for new users who may have questions or encounter issues.

2. Customizable Features: Bambi allows users to customize certain aspects of the software to fit their specific needs. This flexibility ensures that the software adapts to the provider's workflow rather than the other way around.

3. Regular Updates: Bambi continually improves its software through updates and user feedback. This means that even if users are already familiar with the software, they can benefit from new features and enhancements without a steep learning curve.

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Conclusion

Bambi NEMT Scheduling and Dispatch Software stands out as an excellent—actually, the best—choice for NEMT providers due to its critically easy-to-use and non-complicated, user-friendly design. Bambi empowers NEMT providers to focus on their core mission: ensuring timely and reliable transportation for individuals with medical needs. If you're in the NEMT business and looking for a scheduling and dispatch software that delivers results without a steep learning curve, reach out. We won’t we disappoint.

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NEMT Experts Podcast Episode 4: How to Win Private Pay NEMT Work

Bambi CEO Nirav Chheda interviewed NEMT expert Chris Diiorio on how to win private pay NEMT work from healthcare facilities. Chris has been running PrimeCare Transport Services in Denver for 8 years, and 95% of his business is private pay.

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See the full interview at: https://youtu.be/JpFzgberyzs

Please don't forget to subscribe and like NEMT Experts Podcast: https://www.youtube.com/@bambihealth

Podcast Show Notes:

Key Takeaways

• Focus on reliability and service: The best way to win facility business is to consistently show up on time and provide a safe, positive patient experience. "Everything else doesn't matter...they do always end up coming back to you."
• Diversify your client base: Don't rely on a single facility (or broker) for all your trips. Build relationships with multiple facilities to spread risk. Maintain contact with case managers even when they move to other locations.
• Be transparent with facilities: Coordinate schedules with facilities to maximize efficiency. If you must limit availability, explain the business reasons behind it. "[Y]ou don't tell the airline when you're getting on the plane."
• Justify your pricing: Be prepared to explain your rates, especially for longer distances, with a breakdown of costs. Show the facility how the length of a typical transportation process impacts your bottom line.
• Use fees as an educational tool: When necessary, charge fees (e.g., cancel on scene) to highlight communication issues and encourage better coordination on the facility's end.

Important Quotes

• "Just really building one model that show up show up on time and provide a good experience for the patient."
• "Putting all your eggs in one basket...if that broker loses the contract, you lose all your trips."
• "We can be great communicators, so that their patients feel safe when they're with us."
• "If you're 100% accommodating, then you're going to put yourself in a bind and you're going to lose that business."
• "My rate equals three hours of payroll...our margins are slim. So if you're honest with them, and explain to it, I think they get it."

Here are some time-stamped show notes:

00:00 Introduction

‍01:07 Winning over facilities

‍02:48 Coordinating with facilities

‍04:37 Setting pricing/rates

‍07:23 Conclusion

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NEMT Experts Podcast Episode 3: Four Creative Ways to Boost Profit

Bambi CEO Nirav Chheda interviews NEMT expert Courtney Muchugu on the creative ways for an NEMT business to boost revenue and reduce costs. Courtney has been on a NEMTAC advisory board, operated a 40-vehicle NEMT company in Massachusetts for 10 years, and consults for NEMT companies.

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See the full interview at: https://youtu.be/UUfPQZ1AItk

Please don't forget to subscribe and like NEMT Experts Podcast: https://www.youtube.com/@bambihealth

Podcast Show Notes:

Key Takeaways

• Diversify your client base: Don't depend on a single source of trips (broker or facility). Build relationships with multiple partners to spread risk and gain volume flexibility.
• Understand & communicate your costs: Know your operational expenses and explain them to facilities to justify your pricing. Transparency builds trust and can win business.
• Be honest and upfront: Don't overpromise on your capabilities. Set realistic expectations with facilities, and consider a phased takeover of their transport if your current capacity is limited.
• Research and development is key: Continuously look for new software and systems to improve efficiency. Invest time in finding solutions that can save you money and time in the long run.
• Network to find the best solutions: Join organizations like NEMTAC, attend conferences, and even consult with brokers to learn what systems and strategies other successful NEMT companies are using.
• Use multiple platforms to find drivers:  Leverage Indeed, Craigslist, and crucially, referrals from your own top-performing drivers.
• Invest in candidate filtering: Be clear about NEMT's specific requirements during the recruiting process upfront to avoid wasting time with unqualified candidates.
• Prioritize safe drivers: Focus on recruiting individuals with good driving records to set your company up for lower insurance rates in the future.
• Analyze insurance needs carefully: Work with your agent to identify areas for cost savings (e.g., potentially dropping comprehensive/collision coverage). Consider strategic decisions about the locations you serve to impact your insurance costs positively.

Important Quotes

• "Everyone's human...figure out what their problems are, and if you can realistically do anything to solve them." -Courtney on approaching facilities
• "If you're a newer company...start off by hiring drivers that are well trained, and are safe drivers, and maintain a really good driving history for your company, set yourself up for future success." -Courtney on insurance costs
• "If you're going to a lot of the smaller towns, [your insurance cost is] going to be less expensive." -Courtney on strategic location decisions

Here are some time-stamped show notes:

00:00 Introduction

‍00:50 Managing brokers & private pay

‍06:15 Finding new tech systems

‍11:04 Finding drivers

‍16:20 Insurance

‍21:45 Ending

NEMT Experts Podcast Episode 2: The 16 Steps to Launch NEMT Operations

Bambi CEO Nirav Chheda interviews NEMT expert Courtney Muchugu on the creative ways for an NEMT business to boost revenue and reduce costs. Courtney has been on a NEMTAC advisory board, operated a 40-vehicle NEMT company in Massachusetts for 10 years, and consults for NEMT companies.

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See the full interview at: https://youtu.be/DU3VQBZSlUw

Please don't forget to subscribe and like NEMT Experts Podcast: https://www.youtube.com/@bambihealth

Podcast Show Notes:

Key Takeaways

• NEMT is about people: Begin by fully understanding the commitment and service-oriented mindset needed to succeed in transporting patients. "You're dealing with people...all different kinds of backgrounds..."
• Market research is key: Know the demand in your area (elderly, disabled populations, etc.) and the existing competition. This dictates your strategy for finding trips and building volume.
• Regulation varies by state: Reach out to your state Medicaid office, and any applicable brokers, to fully grasp requirements for everything from insurance to driver training.
• Align expectations of costs: Be prepared for significant investments in vehicles, insurance, software, compliance, and most importantly, labor costs.
• Seek legal expertise: Consult a business attorney on the right structure for your company (LLC, sole proprietorship, etc.) based on your short-and-long-term goals.
• Insurance is your shield: Understand what your state/broker requires and have sufficient coverage. "That is the buffer between you and your business going out."
• Authority requirements vary: Know if your business will operate within your state only or across state lines. This affects whether you need USDOT numbers, an interstate operating authority, etc.
• Understand broker standards: Thoroughly read broker contracts, paying attention to performance metrics, wait times, reporting standards, and any other unique requirements.
• Invest in your drivers: Seek out compassionate people truly willing to serve a vulnerable population. Run required background checks, have clear upfront conversations, and offer top-notch training. "Doing as much as you can on the front end...saves you time on the back end."
• Dispatch software is essential: Efficiently assign trips, plan routes, track vehicles, and increase driver satisfaction. "Having software...is by far the greatest thing since NEMT became an available service."
• Billing = Cashflow: Have dedicated personnel to quickly, transparently, and accurately invoice your brokers/Medicaid to keep your business afloat.
• Stay compliant, stay in business: Check in regularly on state/broker/Medicaid requirements as things often change.
• Don't skimp on taxes: Consult a tax pro to understand your obligations, and potentially have a second set of eyes review your filings as laws evolve.

Important Quotes

• "When you're owning and running an NEMT business, you're dealing with people, people, all different kinds of backgrounds, ethnicities, social determinants, health determinants, all those things." -Ray on the service aspect of NEMT
• "The number one thing that catches people up...is understanding what each state or each region's regulatory requirements are." -Ray on state-by-state variation
• "Insurance is probably the second highest expense that a company will have outside of labor costs."-Ray emphasizing the substantial investment
• "I cannot stress how important [dispatch software] is." -Ray
• "Getting paid is what keeps the business going" -Ray on the importance of accurate, timely billing practices

Here are some time-stamped show notes:

00:00 Introduction

‍1:25 Deciding to open an NEMT business

‍2:30 Market Research

‍5:58 State Regulation and Requirements

‍8:51 Aligning Expectations of Cost

‍12:33 Creating Business Structure

‍13:59 Obtaining Insurance

‍16:07 USDOT, MC Numbers, and Authority Requirements

‍18:02 Registering with Medicaid Office/Broker

‍20:12 Regulatory/Compliance Requirements

‍21:51 Hiring Drivers/Staff

‍24:40 Training Staff

‍25:37 Dispatching Software

‍28:00 Accounting Personnel/Software

‍29:43 Billing/Submitting Claims

‍30:58 State Business Authority Requirements

‍32:01 Taxes

‍33:37 Ending

NEMT Operators NEED a Live Calendar View

As the NEMT industry continues to grow, leveraging technology becomes crucial for companies aiming to maintain quality service while scaling their operations. One of the most valuable technological tools for NEMT companies today is dispatch software that offers a live calendar view of their fleet's daily schedules. Here's a deep dive into its importance and benefits:

Real-time Fleet Monitoring

With a live calendar view, NEMT providers can instantly see where each vehicle in their fleet is at any given moment. This real-time visualization means managers can identify potential issues such as delays or unforeseen traffic conditions, and act swiftly to resolve them.

Enhanced Productivity

By having an organized, visual overview of the daily schedules, dispatchers can optimize routes, reduce downtime, and maximize the utilization of every vehicle. This level of operational efficiency ensures more patients are served in less time, improving overall productivity.

Streamlined Scheduling

Traditional scheduling methods, like spreadsheets or even paper-based systems, can be tedious and error-prone. With live calendar dispatch software, scheduling becomes automated and streamlined, minimizing the chances of double bookings or overlooked appointments.

Improved Communication

A comprehensive dispatch system enhances communication between dispatchers and drivers. With real-time updates, drivers can be notified of any changes to their schedule immediately, allowing for better route planning and time management.

Patient Satisfaction

At the end of the day, the goal is to provide patients with reliable and punctual transportation. A live calendar view ensures fewer scheduling mistakes, leading to fewer missed or delayed appointments. When patients can trust their NEMT provider to be on time, their overall satisfaction increases.

Cost Efficiency

Operational hiccups can be costly. Whether it's wasted fuel from inefficient routes or the reputational damage from missed appointments, these missteps can hurt an NEMT company's bottom line. Dispatch software reduces these inefficiencies, ultimately saving companies money in the long run.

Scalability

As an NEMT company grows, so does the complexity of managing a larger fleet and more appointments. Using dispatch software with a live calendar view enables companies to scale more smoothly, handling increased demand without compromising service quality.

Data Analytics

Modern dispatch systems don't just offer scheduling solutions. They often come with analytics tools that allow companies to assess performance metrics, like average wait times, route efficiencies, and more. By understanding these metrics, NEMT providers can continuously refine their services.

Compliance and Reporting

Given the nature of the service, NEMT providers often need to adhere to specific regulations. Dispatch software can help ensure compliance by maintaining accurate logs of trips, driver activities, and vehicle maintenance.

Competitive Edge

In a growing industry, differentiation is key. Companies that leverage advanced technologies like live calendar dispatch software position themselves as modern, efficient, and reliable, giving them a competitive advantage in the market.

As the NEMT sector continues to evolve, companies must adapt and innovate. Adopting dispatch software with a live calendar view is not just a technological upgrade; it's a strategic move that brings about tangible benefits in service quality, operational efficiency, and overall growth. For NEMT providers aiming to be at the forefront of their industry, investing in such tools like Bambi is not just helpful – it's essential.

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Scheduling Optimization in NEMT

Non-Emergency Medical Transportation (NEMT) is a specialized industry that has seen significant strides in enhancing efficiency and client satisfaction. Central to these advancements are route optimization and schedule optimization. However, between the two, schedule optimization has often posed a more intricate puzzle for providers, holding significant value in its resolution.

Route Optimization: A Solved Puzzle

With the advancement of technology and mapping algorithms, route optimization is a problem that has largely been conquered. Tech giants like Google have invested heavily in refining and perfecting their route algorithms. These systems consider current traffic conditions, road closures, and other real-time variables to chart the quickest and most efficient route from point A to B. Given the availability of such sophisticated technologies, it's almost redundant for a NEMT dispatch company to invest resources in building their own route optimization. Relying on tried-and-tested solutions from leading companies ensures precision, reliability, and timely transportation.

The Complexity of Schedule Optimization

In contrast, schedule optimization is a multifaceted challenge. It's not just about the quickest route but ensuring a harmonious alignment of various moving parts. It requires considering patient appointment times, vehicle capacity, driver availability, and vehicle location. Add to this the dynamic nature of medical appointments—where timings can change or be rescheduled—and the challenge grows. Every decision made in the scheduling process can have cascading effects. For instance, if a vehicle that caters to wheelchair-bound patients is unavailable, it impacts multiple appointments and necessitates real-time adjustments to the entire schedule.

Why Schedule Optimization Holds Greater Value

The value proposition of schedule optimization is immense. Properly optimized schedules ensure maximum productivity, reducing operational costs. It guarantees the best use of every available resource, from vehicles to drivers.

More than just operational efficiency, there's the invaluable aspect of patient satisfaction. Patients trust NEMT providers for timely transportation crucial for their health. Delays or mismanagement leading to missed appointments can have serious health and financial consequences for patients. An efficient schedule not only ensures punctuality but significantly elevates patient trust and satisfaction.

Furthermore, in the dynamic world of NEMT, where unexpected challenges are part of the norm, a well-optimized schedule offers resilience. It allows for flexibility to adapt and reconfigure based on unforeseen changes, ensuring that the service quality remains consistently high.

Lastly, from a financial perspective, optimizing schedules not only reduces immediate operational costs but ensures the long-term financial viability of NEMT providers. It reduces the risk of penalties associated with missed appointments and optimizes indirect costs like fuel and maintenance by preventing unnecessary trips.

Conclusion

Route optimization is a challenge that has already been addressed by tech behemoths. For NEMT providers, the real frontier to conquer is schedule optimization. As they adopt software like Bambi, the potential rewards in terms of operational efficiency, patient satisfaction, and financial health are immense.

NEMT Experts Podcast Episode 1: NEMT Optimized with AI - LIVE from NEMTAC 2023

Bambi CEO Nirav Chheda gave a lively presentation at the NEMTAC 2023 conference that explained with examples about how AI is bringing NEMT scheduling and dispatching into the future.

Some detailed examples included: how statistical models can tell you which trips to accept and reject in order to maximize profit, how software can predict your fleet's capacity to take on new trips, how algorithms can find space for new trips by re-assigning and shuffling around trips among your existing drivers' schedules, and how machine learning can help predict the timing of will-call trips.

Nirav also threw chocolate at people, and a jolly good time was had by all!

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For your edutainment, see the talk at https://youtu.be/KoOZJJuYx4E

Please don't forget to subscribe and like NEMT Experts Podcast: https://www.youtube.com/@bambihealth

Podcast Show Notes:

Key Takeaways

• The biggest challenge for NEMT providers is that their costs are increasing while their reimbursement rates are not. This squeezes their profit margins.
• Traditional route optimization software focuses on maximizing the number of trips while minimizing the total distance traveled by the fleet. This approach does not consider profitability.
• AI-based route optimization software can calculate profit at a per trip level by considering various factors such as operating costs, fuel costs, labor costs, and depreciation schedules.
• This allows NEMT providers to make data-driven decisions about whether or not to accept a trip.
• AI can also predict future trip volumes and driver availability, which helps NEMT providers to plan their schedules more effectively.
• Machine learning can be used to analyze historical data on will-call trips (hospital discharges) to predict wait times and appointment lengths, further improving the efficiency of NEMT operations.

Bambi Revolutionizing NEMT with AI

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In the fast-paced world of NEMT, the efficient scheduling and dispatching of rides is crucial for ensuring timely and reliable service for passengers. Traditionally, this process has relied on manual efforts, involving extensive coordination and meticulous planning. However, with the advancements in artificial intelligence (AI) technology, NEMT companies can now leverage automated systems to handle the heavy lifting of scheduling and dispatching, significantly reducing the burden on human personnel, enhancing efficiency, and improving the overall passenger experience.

AI-powered systems are transforming the way NEMT companies handle their scheduling processes. Previously, human schedulers would spend countless hours organizing trips, considering various factors such as passenger availability, driver availability, vehicle capacity, and route optimization. This manual process often led to errors, inefficiencies, and delays.

Now complex algorithms and machine learning models can analyze vast amounts of data to optimize scheduling decisions. These systems take into account factors including: passenger preferences, real-time traffic conditions, historical trip data, driver availability, driver skills and credentials, vehicle capacities, payer service level agreements, driver salaries, and more. By considering all these variables simultaneously, AI algorithms can generate efficient and accurate schedules within seconds, eliminating the need for time-consuming manual calculations.

Dispatching is another critical aspect of NEMT operations that AI systems are revolutionizing. Traditionally, dispatchers would manually assign trips to available drivers, considering factors like proximity, driver skills, and vehicle compatibility. This process was often prone to human error, leading to suboptimal assignments and delays.

AI-powered dispatching solutions can automatically match trips with the most suitable drivers based on a range of variables. By analyzing real-time data from GPS systems, traffic information, and driver availability, AI algorithms can intelligently allocate trips to drivers in the most efficient manner. This optimization ensures reduced wait times, shorter travel distances, and improved overall service quality for passengers.

AI systems also offer increased efficiency, leading to lower costs for NEMT companies. One of the key areas of improvement is the ratio of loaded to unloaded miles, which is crucial for cost-effective operation.

Traditionally, inefficient scheduling can result in vehicles traveling long distances without passengers — known as "deadhead" or unloaded miles. These trips represent a significant cost for NEMT companies in the form of unnecessary fuel consumption, vehicle wear and tear, and the overall cost of operations. AI systems, however, can minimize these unloaded miles. By taking into account variables like the locations of pick-ups and drop-offs, driver availability, and current traffic conditions, AI can ensure that vehicles are loaded with passengers as much as possible. This not only reduces wasted miles and related costs, but also allows NEMT providers to serve more passengers within a given time frame, reducing the waiting time for those in need of transportation.

Moreover, AI systems can continuously learn and adapt based on historical data, allowing them to optimize scheduling and dispatching decisions over time. These systems can identify patterns (such as the timing of will-call trips), anticipate demand fluctuations, and dynamically adjust schedules and dispatch assignments accordingly. As a result, NEMT companies can save money in the long run by avoiding overstaffing and ensuring that the right number of drivers and vehicles are available at any given time.

One of the most significant advantages of AI-powered scheduling and dispatching systems is the positive impact on the passenger experience. With automated processes, NEMT companies can offer more accurate ETAs, reducing passenger anxiety and uncertainty. Passengers can rely on prompt, reliable service, enhancing trust in their NEMT provider. Additionally, AI systems can incorporate passenger preferences and requirements into the scheduling process for personalized experience, whether it's accommodating wheelchair accessibility, providing language-specific drivers, or accounting for special medical equipment.

The application of AI in the NEMT sector is still in its early stages, but the initial results are promising, as demonstrated by Bambi's powerful full-suit dispatch and scheduling software. As AI technology continues to evolve and improve, particularly by taking on the heavy lifting in scheduling and dispatching, NEMT companies can focus more on their primary mission: providing safe, reliable, and efficient transportation for those who need it most.