Home
Forms Library
Modivcare wv mileage reimbursement

Get the up-to-date wv dhhr mileage reimbursement 2025 now

modivcare wv mileage reimbursement Preview on Page 1

Show details

4 out of 5

41 votes

The document is a supplemental application form for the Non-Emergency Medical Transportation (NEMT) Reimbursement Program by the West Virginia Department of Health and Human Resources. It allows applicants to request reimbursement for transportation costs related to medical visits, including mileage, lodging, meals, and other expenses. The form requires detailed information about the trips, medical provider verification, and must be submitted within 60 days of the first trip.

Here's how it works

01. Edit your modivcare wv mileage reimbursement online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send modivcare wv via email, link, or fax. You can also download it, export it or print it out.

The best way to edit Wv dhhr mileage reimbursement online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making changes to your paperwork requires just a few simple clicks. Make these quick steps to edit the PDF Wv dhhr mileage reimbursement online for free:

Register and log in to your account. Sign in to the editor with your credentials or click Create free account to test the tool’s functionality.
Add the Wv dhhr mileage reimbursement for editing. Click the New Document button above, then drag and drop the file to the upload area, import it from the cloud, or using a link.
Modify your file. Make any changes needed: add text and photos to your Wv dhhr mileage reimbursement, highlight important details, remove sections of content and substitute them with new ones, and insert symbols, checkmarks, and areas for filling out.
Complete redacting the template. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the parties involved.

Our editor is very easy to use and effective. Give it a try now!

See more wv dhhr mileage reimbursement versions

We've got more versions of the wv dhhr mileage reimbursement form. Select the right wv dhhr mileage reimbursement version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2009	4 Satisfied (41 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I apply for mileage reimbursement?

To be reimbursed for your business driving, you must provide your employer with consistent mileage records. They should include information for every business trip, including the date, destination, purpose, and total mileage driven.

Does Medicaid cover transportation in WV?

Modivcare provides transportation for Medicaid Members throughout West Virginia. Members must be attending a covered medical service and be traveling to and from their residence address of record with West Virginia Medicaid.

How much does medical transport services cost?

Ambulatory Services: $25 to $50 one way. Wheelchair Services: $50 to $100 one way. Stretcher Services: $200 to $300 one way. Bariatric transport: Can be over $300 per trip due to special equipment and vehicles.

What is the number for WV Medicaid transportation?

Modivcares customer service center is open from 7 a.m. to 6 p.m., Monday through Friday for scheduling routine appointments. Additionally, urgent requests and hospital discharges are taken 24 hours a day, seven days a week. Please call 1-844-549-8353 to phone in transportation requests.

How to get a ride in West Virginia?

To make a request, please call us at 304-529-7433 or email us at tta@tta-wv.com.

modivcare wv mileage reimbursement form

Wv dhhr mileage reimbursement form Wv dhhr mileage reimbursement form online Wv dhhr mileage reimbursement form pdf Wv dhhr mileage reimbursement phone number WV Medicaid mileage reimbursement WV mileage reimbursement 2024 Modivcare mileage Reimbursement form wv Wv dhhr mileage reimbursement 2022

Related forms

be ready to get more

Complete this form in 5 minutes or less

Get form

What does my Medicaid cover in WV?

If you qualify, you will be able to visit doctors and specialists at little or no cost. You will also receive dental, vision, and mental health coverage. Any prescription drugs that you take will often be less expensive, too.

What is the mileage reimbursement law in West Virginia?

For state employees in West Virginia, mileage reimbursement is not just a courtesy its a legal requirement. The current rate is 70 cents per mile, as set by the Department of Administrations Purchasing Division, effective January 1, 2025.

Get the up-to-date wv dhhr mileage reimbursement 2025 now

Here's how it works

The best way to edit Wv dhhr mileage reimbursement online

See more wv dhhr mileage reimbursement versions

Complete this form in 5 minutes or less

Got questions?

How do I apply for mileage reimbursement?

Does Medicaid cover transportation in WV?

How much does medical transport services cost?

What is the number for WV Medicaid transportation?

How to get a ride in West Virginia?

Complete this form in 5 minutes or less

People also ask

What does my Medicaid cover in WV?

What is the mileage reimbursement law in West Virginia?

modivcare mileage reimbursement form wv

Try more PDF tools