First Transit RTN Submission Instructions and Forms
This file provides detailed instructions and forms for submitting RTN (Return Trip Number) requests to First Transit. It includes guidelines for single trips, standing prior authorizations, and necessary information to complete the forms. Users can find contact details for phone, fax, and mailing submissions.
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How do I fill this out?
To fill out the forms, gather all required information about the participant and the trip. Ensure all fields are accurately completed and legible. Follow the specific submission instructions provided for each form.
How to fill out the First Transit RTN Submission Instructions and Forms?
1
Gather required information about the participant and trip.
2
Fill out all fields on the form accurately and legibly.
3
Attach any necessary supporting documentation.
4
Follow the submission instructions for phone, fax, or mail.
5
Ensure that the form is submitted within the required timeframe.
Who needs the First Transit RTN Submission Instructions and Forms?
1
Healthcare providers who need to arrange non-emergency medical transportation for patients.
2
Participants requiring transportation to medical appointments.
3
Dialysis centers arranging regular transportation for patients.
4
Long-term care facilities coordinating transportation for residents.
5
NET providers assisting participants with transportation needs.
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Fill out the required fields with accurate information.
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Attach any necessary supporting documents.
4
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5
Save and share the completed form for submission.
What are the instructions for submitting this form?
To submit the RTN forms, you can call First Transit at (866) 503-9040, fax the form to (630) 873-1450, or mail it to 799 W Roosevelt Rd., Bldg 4, Suite 200, Glen Ellyn, IL 60137. Ensure all fields are completed accurately and attach any necessary supporting documentation. Submit the form within the required timeframe to avoid delays. Make sure to provide legible and detailed information to facilitate processing.
What are the important dates for this form in 2024 and 2025?
Ensure all RTN requests are submitted within the required timeframes for 2024 and 2025, as specified by First Transit guidelines.
What is the purpose of this form?
The purpose of these forms is to facilitate the submission of RTN (Return Trip Number) requests to First Transit for non-emergency transportation needs. The forms include options for single trips and standing prior authorizations, providing detailed instructions on how to complete and submit them. They ensure that all necessary information is collected to arrange transportation efficiently.
Tell me about this form and its components and fields line-by-line.
- 1. Name of the Individual: Enter the first and last name of the individual requiring transportation.
- 2. Phone Number: Provide the contact phone number of the individual.
- 3. Address: Include the street, city, and ZIP code of the individual's address.
- 4. RIN Number: Enter the Recipient Identification Number (RIN) assigned to the participant.
- 5. Ambulatory or Wheelchair: Indicate whether the individual is ambulatory or uses a wheelchair.
- 6. Date of Appointment: Specify the date of the upcoming appointment.
- 7. Time of Appointment: Provide the time of the scheduled appointment.
- 8. Pick Up Address: Enter the address where the individual will be picked up.
- 9. Drop off Address: Provide the address of the facility where the individual will be dropped off.
- 10. Doctor's Name: Include the first and last name of the attending doctor.
- 11. Facility Name: Enter the name of the facility where the appointment will take place.
- 12. Facility Address: Provide the full address of the facility.
- 13. Doctor's Office Phone Number: Include the contact phone number of the attending doctor's office.
- 14. Reason for the Trip: Specify the reason for the trip with as much detail as possible.
What happens if I fail to submit this form?
Failure to submit the RTN form accurately and within the required timeframe may result in denied transportation requests and delays in arranging necessary appointments.
- Denial of Request: Your transportation request may be denied if the form is incomplete or not submitted on time.
- Delayed Appointments: Failure to arrange transportation in a timely manner may result in missed or delayed medical appointments.
How do I know when to use this form?
- 1. Scheduling a Single Trip: Use the Single Trip form to arrange a one-time transportation request.
- 2. Standing Prior Authorization: Use the SPA form to arrange recurring transportation for ongoing treatments.
- 3. Emergency Transportation: Ensure emergency transportation requests comply with First Transit's guidelines.
- 4. Long-Term Care Facility Arrangements: Facilities can use the form to arrange transportation for residents.
- 5. Dialysis Center Appointments: Centers can use the form to coordinate transportation for patients.
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Yes, you can share the completed form via email or generate a shareable link using PrintFriendly's sharing options.
What information do I need to complete the RTN form?
You need detailed information about the participant, the trip, and any supporting documentation requested by First Transit.
How do I submit the completed RTN form?
Follow the submission instructions provided in the file, including phone, fax, and mailing options.
What should I do if my RTN request is denied?
You can resubmit the request with the required documentation as specified by First Transit.
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How do I know my RTN form is completed correctly?
Ensure all fields are filled out accurately and legibly, and attach any necessary supporting documentation before submitting.
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