Medicaid TPL

Medicaid TPL


Send TPL on Medicaid Secondary Claims

Overview

TPL: Third Party Liability

    

State Medicaids may require the TPL in different places in ANSI Loop 2330B and can be different for each Payer address.

  • Use the TPL ANSI Field Group to add the TPL Code.
  • Depending on the State, the System will put the TPL in the Segment where it belongs.


ANSI Field Groups

  • Example 1: Illinois Medicaid requires the TPL in Loop 2330B in the REF02 segment with a 2U Identifier.
  • Use the ANSI Field Groups to populate the TPL with the 2U Identifier on the MCDIL Secondary Claims.

  • Example 2: Massachusetts Medicaid requires the TPL in Loop 2330B NM109 segment.  This replaces the Payer ID on MCDMA Secondary Claims.


Payers: TPL Required in Loop 2330B REF Segment with 2U Identifier

  • Illinois Medicaid
  • Arizona Medicaid
  • SC Medicaid


Payers: TPL required in Loop 2330B NM109

  • Massachusetts


ANSI Field Groups

  1.  On the Encounter Dashboard, select the Modify button.

  1. Using the Lookup icon, select TPL.

  1. ANSI Field Group pop-up:
  • Enter TPL code in boxes 37A and 38A.
  1. Select Save [F2].

If you don't need box 38A, select the Keys icon to set the field to Not Mandatory. 

  1. Select Save [F2] on the Modify Charge screen.


Send Additional Information

  1.  From Charges on the Left Side Menu, select the Post Charge button.

  1. Select TPL in the ANSI field. Learn More: Illinois Medicaid TPL Code
  • 37A: TPL Code
  • 37B: TPL Status
  • 37C: TPL Amount
  • 37D: TPL Date
  • 38A thru 38D are the same as above for additional TPL information.
  1. The TPL information displays on the paper (HCFA) Claim and on the Electronic Claim in ANSI Loop 2330B.




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