dmas webex training third party liability (tpl) training july 2012

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Department of Medical Assistance Services

DMAS WebEx TrainingThird Party Liability (TPL) Training

July 2012

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Department of Medical Assistance Services

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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

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Department of Medical Assistance Services

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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.

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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 When the policy is no longer active, all coverage lines and the policy must be end dated.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.

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Department of Medical Assistance Services

Adding a TPL Policy

• Select TPL Resource Inquiry/Update• Select Add• Select Enter

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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

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Department of Medical Assistance Services

Adding a TPL Policy (cont.)

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Department of Medical Assistance Services

Updating a TPL Policy

• Select TPL Resource Inquiry/Update• Select Change• Select Enter

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Department of Medical Assistance Services

Updating a TPL Policy (cont.)

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Department of Medical Assistance Services

Updating a TPL Policy (cont.)

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Department of Medical Assistance Services

Updating a TPL Policy (cont.)

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Department of Medical Assistance Services

Updating a TPL Policy (cont.)

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Department of Medical Assistance Services

Updating a TPL Policy (cont.)

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Department of Medical Assistance Services

Deleting a TPL Policy

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Department of Medical Assistance Services

Deleting a TPL Policy (cont.)

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Department of Medical Assistance Services

Deleting a TPL Policy (cont.)

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Department of Medical Assistance Services

Deleting TPL Policy (cont.)

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Department of Medical Assistance Services

Deleting TPL Policy (cont.)

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Department of Medical Assistance Services

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

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Department of Medical Assistance Services

Medicare Buy-InAssistance with state buy-in are directed to the Buy-In Unit :

MedicareBuyIn@dmas.virginia.govDepartment 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.

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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 Specialistmmiswebex@dmas.virginia.gov