6/6/17

This Communique provides instruction related to authorizing non-medical EW transportation in the North Western and Central areas of Minnesota. BluePlus has been working to streamline the process for requesting and authorizing non-medical transportation in those areas of the State that have access to a bus system or other community transportation.

Effective immediately,the process to authorize non-medical, EW Transportation when purchasing a bus pass or tokensin those communities that are served by MATBUS, Friendly Rider and Productive Alternatives is as follows (examples on pg 2):

  1. Complete a service agreement in Bridgeview using the following:
  2. Request Date
  3. Provider NPI: UMPI 652870 (MATBUS)

UMPI 542871 (Friendly Rider)

1285923490 (Productive Alternatives)

  1. Service Code “T2003 UC”
  2. “To” and “From” date
  3. List in the Service Description field
  4. New pass OR
  5. Existingpass
  6. Description of Pass
  7. Monthly amount for pass (see Pg. 3)

f. Total units authorized: monthly units multiplied by number of months auth (5900 units x 4 months = 23600)

g. Rate Per Unit: $0.01

h. Total Authorized Amount: total units authorized multiplied by $0.01 (this example is $236.00)

i. Apply Waiver: Yes

j. Prorated: “NO” (this should always be NO)

k. Frequency: “Flexible”

l. Select Provider Reason Code: select appropriate reason code based on your authorization

New Service agreements will be processed weekly and bus passes/tokens will be mailed to each member.

Lost Bus Passes: Members must contact Care Coordinators if bus pass is lost or stolen and those issues should be reported to the

If you are having issues with member bus cards or tokens please send an email to

Thank you,

Partner Relations

Below are examples of Service Agreements for bus passes:

Midmonth example: Regardless of the start date being authorized, please create your service agreement based on one month. For example if you want to authorize $70(same as 7000 units) monthlyand you want to start your pass 3/15/17 to 02/28/18, you would multiply your monthly units of 7000 by 12 months ($0.01 per unit) = 84,000 total units authorized. Even though you are starting your service agreement midmonth, you will still authorize the full monthly amount and count it as a full month for purposes of calculating your total units authorized.

BECKER COUNTY: Friendly Rider (Becker County Transit)

Bags of tokens: 10 to a bag for $15 The rides are $1.50 each way for 0-5 miles.

NPI, UMPI, or tax id: 41-6005754

CLAY COUNTY: MATBUS

For our disabled members contact Moorhead at 701-476-6782 for a service voucher to be filled out.

Federal tax ID # 45-6002069

Services Fargo, Moorhead, Dilworth, West Fargo

$26 unlimited pass for 30 days

Packet =20 individual tickets for $15 or 10 ride card for $7.50

OTTERTAIL COUNTY: Productive Alternatives/ Otter Express

Punch pass=10 for $15

Unlimited=$60

Serves Parkers Prairie, Perham, Fergus Falls

UMPI: 1285923490

WILKIN COUNTY: (also under Ottertail County) (Productive Alternatives)

Serves Breckenridge

10 rides =$15 punch pass

UMPI: 1285923490

Blue Cross® and Blue Shield® of Minnesota is a nonprofit independent licensee of the Blue Cross and Blue Shield Association