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Medical Transportation Management, Inc. (MTM) fax number

(888) 513-1610

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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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