Book Your Ride

Schedule a Ride

Complete the form below and our dispatch team will reach out to confirm your ride details.

How to Request a Ride

Patients with Medicare

• Have your Member ID number ready
• Call and ask for: RAM / Miracle Medical Transportation
• Provider ID: 517573
•BCBS Community / BCCHP: 1-877-831-3148
• Other ModivCare or MCO plans: call the number on the back of your insurance card
• Once the trip is booked and assigned to us, you are done

Patients with Medicaid Insurance

• Have your RIN ready (RIN = Recipient Identification Number)
•Call Medicaid Transportation / NETSPAP: 1-877-725-0569
• Ask for: Miracle Medical Transportation
• After you receive your RTN, call our dispatch with your trip information

Please call at least 3 days before your trip.

Last-minute trips may be possible with proper verification.

72-Hour Advance Notice Required

All ride requests must be submitted at least 72 business hours before your appointment. This allows our team to coordinate the best route and schedule for you.

Medicaid Riders: Get Your RTN First

If you have Medicaid, you must call Medicaid Transportation / NETSPAP at 1-877-725-0569 to obtain a trip pre-approval number (RTN) before submitting this form. We cannot process Medicaid rides without a valid RTN.

About Our Shared-Ride Service

As a shared-ride provider, our goal is to get you to your appointment at least 15 minutes early. Depending on the best route schedule, you may arrive 40 to 45 minutes before your appointment time.

Ride Request Form

Fill out all required fields and our team will contact you to confirm.

Full Name *

Email Address *

Phone Number *

Payment Type *

Medicaid Trip Pre-Approval (RTN)

You must call Medicaid Transportation / NETSPAP at 1-877-725-0569 to get your RTN before submitting. Enter it below.

RTN Number *

Pickup Address *

Drop-off Address (Medical Facility) *

Appointment Date *

Appointment Time *

Mobility Needs

Additional Notes

HIPAA Privacy Notice

By submitting this form, you acknowledge that the personal and health-related information you provide will be used solely for the purpose of coordinating your non-emergency medical transportation. Miracle Medical Transportation, LLC is committed to protecting your privacy in accordance with HIPAA. Your information will not be shared with unauthorized third parties.

I acknowledge the HIPAA Privacy Notice and consent to the use of my information for transportation coordination. *

Prefer to call? Reach our team at 708-833-7087 (Chicagoland) or 217-978-7433 (Springfield/Decatur).