Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Medical Transportation Management, Inc. (MTM) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Medical Transportation Management, Inc. (MTM) fax number

(888) 513-1610

Trip Logs

Used for: Submit trip logs for mileage reimbursement; MTM verifies trips and then loads funds to the member's Focus Card after verification.

Fax destination details

Department
Trip Logs
Purpose
Submit trip logs for mileage reimbursement; MTM verifies trips and then loads funds to the member's Focus Card after verification.
Form
Trip Log — Trip Log for Mileage Reimbursement
Address
16 Hawk Ridge Drive, Lake St. Louis, MO 63367
Voice phone
1-888-597-1192

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fill out the Trip Log with trip details; have a provider sign for each trip; submit within MTM's guidelines (e.g., within 60 days as applicable). MTM verifies the information and processes mileage reimbursement.

Review official form instructions

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