1 Department of Medical Assistance Services DMAS WebEx Training Third Party Liability (TPL) Training July 2012

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Presentation transcript:

1 Department of Medical Assistance Services DMAS WebEx Training Third Party Liability (TPL) Training July Department of Medical Assistance Services

2 Department of Medical Assistance Services Agenda Overview of TPL Policies Adding a TPL Policy Updating a TPL Policy Deleting a TPL Policy Added in Error 2 Department of Medical Assistance Services

3 Department of Medical Assistance Services Third Party Liability Policies A Third Party Liability (TPL) policy is any health insurance that an applicant has. Applicants must provide information about TPL policies. The LDSS must enter the policy data into the MMIS even if the information is incomplete. Do NOT enter information regarding Medicare Advantage plans into the MMIS for Members who have both Medicare and a Medicare Advantage plan.

4 Department of Medical Assistance Services TPL Policies End date any coverage and or policy when no longer active. When the policy is no longer active, all coverage lines and the policy must be end dated. Delete any coverage or policy if either was added in error. *Note: While this is referred to as “retiring” a policy in the MMIS, this process is only used when the policy NEVER existed for the member and needs to be DELETED.

5 Department of Medical Assistance Services Adding a TPL Policy Select TPL Resource Inquiry/Update Select Add Select Enter Select TPL Resource Inquiry/Update Select Add Select Enter

6 Department of Medical Assistance Services Adding a TPL Policy (cont.) Mandatory Fields: Member ID Source Policy Number Rel Policy Type Carrier Code Status Begin Date Verify Cov Begin Date End Date if applicable Mandatory Fields: Member ID Source Policy Number Rel Policy Type Carrier Code Status Begin Date Verify Cov Begin Date End Date if applicable

7 Department of Medical Assistance Services Adding a TPL Policy (cont.)

8 Department of Medical Assistance Services Updating a TPL Policy Select TPL Resource Inquiry/Update Select Change Select Enter Select TPL Resource Inquiry/Update Select Change Select Enter

9 Department of Medical Assistance Services Updating a TPL Policy (cont.)

10 Department of Medical Assistance Services Updating a TPL Policy (cont.)

11 Department of Medical Assistance Services Updating a TPL Policy (cont.)

12 Department of Medical Assistance Services Updating a TPL Policy (cont.)

13 Department of Medical Assistance Services Updating a TPL Policy (cont.)

14 Department of Medical Assistance Services Deleting a TPL Policy

15 Department of Medical Assistance Services Deleting a TPL Policy (cont.)

16 Department of Medical Assistance Services Deleting a TPL Policy (cont.)

17 Department of Medical Assistance Services Deleting TPL Policy (cont.)

18 Department of Medical Assistance Services Deleting TPL Policy (cont.)

19 Department of Medical Assistance Services TPL Assistance Assistance with TPL issues are directed to the TPL Unit at: Department of Medical Assistance Services Third Party Liability Unit, 8th floor 600 E Broad St Ste 1300 Richmond VA Phone: Fax:

20 Department of Medical Assistance Services Medicare Buy-In Assistance with state buy-in are directed to the Buy- In Unit : Department of Medical Assistance Services Buy-In Unit, 12th floor 600 E Broad Street, Suite 1300 Richmond Virginia Phone: or Fax:

21 Department of Medical Assistance Services Remember… Thank you for viewing this presentation! Questions or comments regarding this or future presentations can be sent to the Eligibility and Enrollment Unit as follows: Sarah Samick, Program Administration Specialist