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Department of Medical Assistance Services. DMAS WebEx Training Third Party Liability (TPL) Training July 2012. http://dmasva.dmas.virginia.gov. 1. Department of Medical Assistance Services. Agenda. Overview of TPL Policies Adding a TPL Policy Updating a TPL Policy
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Department of Medical Assistance Services DMAS WebEx Training Third Party Liability (TPL) Training July 2012 http://dmasva.dmas.virginia.gov 1
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 http://dmasva.dmas.virginia.gov 2
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.
TPL Policies • End date any coverage and or policy when no longer active. When the policy is no longer active, all coverage lines and the policy must be end dated.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.
Adding a TPL Policy • Select TPL Resource Inquiry/Update • Select Add • Select Enter
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
Updating a TPL Policy • Select TPL Resource Inquiry/Update • Select Change • Select Enter
TPL Assistance Assistance with TPL issues are directed to the TPL Unit at: TPLunit@dmas.virginia.gov Department of Medical Assistance Services Third Party Liability Unit, 8th floor 600 E Broad St Ste 1300 Richmond VA 23219-1834 Phone: 804-786-7931 Fax: 804-786-0729
Medicare Buy-In Assistance with state buy-in are directed to the Buy-In Unit : MedicareBuyIn@dmas.virginia.gov Department of Medical Assistance Services Buy-In Unit, 12th floor 600 E Broad Street, Suite 1300 Richmond Virginia 23219-1834 Phone: 804-786-7414 or 804-371-8888 Fax: 804-786-0973.
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 mmiswebex@dmas.virginia.gov