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Get MI Logisticare Mileage Reimbursement Trip Log 2019-2024

Ct the LogistiCare reservation Line to request blank copies of the form. Please note that your doctor/counselor must sign the form as proof that you were at your appointment. If your form is incomplete, you will not receive payment for your trip. The distance will be calculated as the number of miles from your home to your medical appointment. Here s how it works: 1) When you call to schedule your trip you will receive a trip number. This trip number is required on the reimbursement form. Writ.

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