Payme mtm inc net 2025

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The document outlines the procedures for submitting a Reimbursement Trip Log to MTM for medical appointments. It details the requirements for calling MTM before appointments, obtaining trip numbers, and completing the log accurately. It also specifies submission deadlines, acceptable signatures from healthcare providers, and instructions for documenting multiple trip legs. Additionally, it emphasizes the importance of keeping copies of submitted logs and provides contact information for inquiries.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the 'Member Info' section, including your first name, last name, Medicaid number, and address.
In the 'Payment Info' section, provide the payee's Social Security Number and relationship to the member. Ensure all fields are filled accurately.
Call MTM on or before your medical appointment to obtain a trip number. Write this number down on the Trip Log.
Document each leg of your trip clearly. For example, list home to doctor as the first leg and any subsequent trips accordingly.
Have a healthcare provider sign the Trip Log. This can be any qualified professional at the facility.
Review all entries for completeness before submitting. Incomplete forms cannot be processed.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (167 Votes)
2015	4 Satisfied (50 Votes)
2014	4.4 Satisfied (181 Votes)

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MTM has an overall rating of 3.3 out of 5, based on over 553 reviews left anonymously by employees. 63% of employees would recommend working at MTM to a friend and 63% have a positive outlook for the business. This rating has decreased by 7% over the last 12 months.