PM 20-22-02-b.

  1. FCRC (with Medical Approval Unit) Refer requests for medical transportation to Medical Approval Unit.
  2. FCRC (without Medical Approval Unit) Refer requests for medical transportation to person(s) chosen by Family Community Resource Center administrator.
  3. (FCRC) Use Request for Approval of Medical Transportation (Form 1781) to refer request to correct person or unit.
  4. (Client or Medical Source) Must explain to DHS staff about medical condition and why medical transportation is needed.
  5. (Transportation Approver) Accept client's statement about needing transportation unless:
    • there are inconsistencies in client's statement,
    • the caseworker is aware of different circumstances,
    • the client has a history of giving false information, or
    • other facts raise questions about the request.
  6. (Transportation Approver) Document request.
  7. (Transportation Approver) Complete Transportation Prior Approval Request (Form 2239).

    NOTE: Do not complete Form 2239 when CTA Transit Cards are approved. Complete Authorization for Payment of Transportation Expenses (Form 2366). 

  8. (Transportation Approver) Approve or disapprove request for transportation.
    1. Enter on Form 2239 a prior approval number from the block of numbers for the specific provider type.
    2. Enter different prior approval number for each Form 2239.
    3. Get additional prior approval numbers by calling BCHS (217)782-5565.
  9. (Transportation Approver) Distribute Form 2239.
    1. Send one copy of Form 2239 to provider.
    2. File one copy of Form 2239 in case record.
  10. (Transportation Approver) Document request for CTA Transit Card in case record.
  11. (Transportation Approver) Send client Notice of Decision on Request for Medical Service/Item (Form 2352) when a request is denied.
    1. File one copy of Form 2352 in case record.
  12. (Transportation Approver) 12. Document reason for approving or denying a transportation request in case record.

For clients who need to make multiple trips to the same medical provider over a period of time:

  1. Get written information from medical source about need for trips, within 10 days of approving first trip. The information should include:
    • nature of need,
    • need for ongoing visits,
    • appointment dates,
    • number of visits needed, and
    • how long visits will be needed.
  2. Use Verification of Need/On-going Medical Transportation (Form 1377) if desired, to verify need for repeated trips.
  3. (Transportation Approver) Approve up to 6 months of repeat trips to a medical provider.
  4. (Transportation Approver) Request new medical statement at end of the 6 months, if client needs more trips.