Payer Types 101
Overview of the payers available within Roundtrip.
Within Roundtrip, ride bookers are presented with a variety of payer types to select from at the time of booking. These options allow for flexibility and choice in determining who is responsible for the cost of the ride. The options may include facility paid, patient paid, or insurance paid.
Please note that the available vehicle and payer types in Roundtrip may vary based on the booking organization's settings. The available payer types can also vary depending on the level of transport being booked.
Payer Types in Roundtrip
Facility Paid
When the facility is designated as the payer, the booking organization is responsible for the ride's cost. As a Ride Booker, you must adhere to any of your organization’s internal workflows and requirements, if applicable, before booking a ride as facility paid. For instance, your organization may require patients to meet specific criteria to qualify for a facility paid ride or administrator approval may be needed.
Depending on the booking organization’s billing configuration with Roundtrip, Roundtrip may be responsible for paying the assigned Transportation Provider on the organization’s behalf (often referred to as “Roundtrip as the payment intermediary”). Alternatively, if Roundtrip is not the payment intermediary for that particular ride, the assigned Transportation Provider will be responsible for invoicing the booking organization directly for payment.
Patient Paid
When the Patient or Rider is designated as the payer, this means the Rider is responsible for the ride cost. There are two different subcategories for Patient Paid rides within Roundtrip:
Patient Pay by Card
When scheduling in Roundtrip, the Ride Booker can enter the Rider’s credit card information for payment. A hold will be placed on the card for the estimated ride cost once the ride is booked.
When the ride is completed within Roundtrip, the actual ride cost will be charged to the Rider’s credit card, replacing the original hold. Roundtrip will then provide payment to the assigned Transportation Provider according to our standard payment schedule.
Patient Pay Outside of Roundtrip
When scheduling in Roundtrip, the Ride Booker can opt for payment to be arranged directly with the Transportation Provider. This option cannot be used for Rideshare rides.
When this option is selected, the assigned Transportation Provider will often request payment prior to the transport taking place or at the time of pickup. In some cases, Transportation Providers may send a bill to the Rider at a later date.
Insurance Paid
When the Rider’s insurance plan is designated as the payer, this means the plan is responsible for the ride cost. Benefits, coverage, and authorization requirements can vary widely by the individual plan as well as the vehicle type booked. If your organization has authorizations in scope with Roundtrip, we will attempt to obtain authorization with the plan and update the authorization status accordingly within the portal.
Transportation Providers are responsible for confirming that they are in-network with the listed plan before submitting an ETA for the ride in Roundtrip. Transportation Providers are also responsible for submitting a claim with the specific plan for payment. Roundtrip will not submit a claim to the insurance plan on the Transportation Provider’s behalf.
There are several different insurance types to choose from within Roundtrip:
Private Insurance (Including Medicare Advantage)
Ride Bookers can opt to book using a Rider’s private insurance plan, including Medicare Advantage plans. Depending on the specific plan and vehicle type booked, authorization may be required.
Medicare
If the Rider has traditional Medicare, they must have active Part B coverage for ground transportation to be covered. In addition, traditional Medicare typically will only cover ambulance level transports.
Medicaid
Medicaid plans typically need to be authorized and arranged with a Broker prior to the requested ride time. If your organization has brokered authorizations in scope with Roundtrip, our team will handle contacting the Broker for authorization and to have the transport scheduled.
For more information about brokered rides, check out our FAQ.
Available Payers Types Based on Vehicle Level
While Roundtrip offers multiple payer types, there are some restrictions on which payers can be selected based on the vehicle type being booked. For example, Rideshare and Taxi rides cannot be booked as insurance paid within Roundtrip.
In addition, if the booking organization is contracted with Roundtrip for authorizations, Roundtrip may also be responsible for obtaining the authorization for rides booked with Medicaid and/or Private Insurance as the payer.
Quick Rules
- Medicaid cannot book Rideshare or Taxi
- Medicare requires Part B for Ambulance
- Private Insurance may vary by plan
- Some payers require authorization before scheduling
- Some rides are coordinated through brokers or routed to Roundtrip Community
Facility
- ✅ Rideshare
- ✅ Taxi
- ✅ Med Sedan
- ✅ Wheelchair (WCV)
- ✅ Stretcher
- ✅ Ambulance
- ❌ Authorization Required
- 📌 Sent to RT Community
Patient
- ✅ Rideshare
- ✅ Taxi
- ✅ Med Sedan
- ✅ Wheelchair (WCV)
- ✅ Stretcher
- ✅ Ambulance
- ❌ Authorization Required
- 📌 Sent to RT Community
Medicaid
- ❌ Rideshare
- ❌ Taxi
- ✅ Med Sedan
- ✅ Wheelchair (WCV)
- ✅ Stretcher
- ✅ Ambulance
- ⚠️ Authorization Required
- 📌 Coordinated with Broker
Medicare
- ❌ Rideshare
- ❌ Taxi
- ❌ Med Sedan
- ❌ Wheelchair (WCV)
- ❌ Stretcher
- ❌ Ambulance (unless Part B)
- ❌ Authorization Required
- 📌 Sent to RT Community
Private Insurance (Medicare Advantage)
- ❌ Rideshare
- ❌ Taxi
- ⚠️ Med Sedan (Varies by Plan)
- ⚠️ Wheelchair (WCV) (Varies by Plan)
- ✅ Stretcher
- ✅ Ambulance
- ⚠️ Authorization Required
- 📌 Sent to RT Community
Private Insurance (All Other Plans)
- ❌ Rideshare
- ❌ Taxi
- ❌ Med Sedan
- ⚠️ Wheelchair (WCV) (Varies by Plan)
- ✅ Stretcher
- ✅ Ambulance
- ⚠️ Authorization Required
- 📌 Sent to RT Community
Medicaid may reimburse for Rideshare or Taxi, but these cannot be booked as Insurance-paid in Roundtrip. If broker bypass rules are configured, rides will automatically route to the Roundtrip Community instead of a broker
- Medicaid may reimburse for Rideshare or Taxi, but these cannot be booked as Insurance-paid in Roundtrip
- If broker bypass rules are configured, rides will automatically route to Roundtrip Community instead of a broker
Check out the graphic below to review the various payer types available within Roundtrip:
