Our #1 Priority is Taking Care of You and Your Patients
Medical Necessity Forms & Other Information
MassHealth Forms & Information
Effective July 1, 2016, MassHealth now requires specific MassHealth-issued Medical Necessity Forms (MNF’s) in order to constitute valid authorization for:
non-emergency wheelchair van transportation provided to MassHealth members who reside in institutional settings;
non-emergency wheelchair van transportation provided to MassHealth members who reside in the community and need mobility assistance from transportation provider personnel to exit their residences or to move from their residences to the vehicle; and
non-emergency ambulance transportation provided to any MassHealth member, regardless of where the member resides.
See the full bulletin issued by the Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid by clicking here for a PDF download.
Don’t Worry! Alert Ambulance is here to make the process as easy as 1-2-3!
We pre-filled these downloadable forms out with our information to save you time!
Find out if the patient needs an Ambulance (stretcher/cot) or a Chair Car (wheelchair) for transportation
Click on the MassHealth PDF form you need below
Print out as many as you need and fill out the information required before our amazing staff arrives to transport your amazing patient