Overview
TPL: Third Party Liability; Some Payers refer to this as a Carrier Code, not to be confused with CFI
State Medicaids may require the TPL/Carrier 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/Carrier Code.
- This will need to be added on the Modify Charge screen on each Claim.
- It will output in Loop 2330B, REF segment or 2330B, NM109 segment depending on the State Medicaid.
- Use a Cross Code (contact support for setup)
- This is set up on the Primary Payer and is only done once.
- Depending on the State, the System will put the TPL in the Segment where it belongs. (2330B Loop, NM109 segment or 2330B Loop, REF segment)
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/Carrier Code Required in Loop 2330B REF Segment with 2U Identifier
- Illinois Medicaid
- Arizona Medicaid
- SC Medicaid
Payers: TPL/Carrier Code required in Loop 2330B NM109
ANSI Field Groups
- On the Encounter Dashboard, select the Modify button.
- Using the Lookup icon, select TPL.
- ANSI Field Group pop-up:
- Enter TPL code in boxes 37A and 38A.
- Select Save [F2].
If you don't need box 38A, select the Keys icon to set the field to Not Mandatory.
- Select Save [F2] on the Modify Charge screen.
- From Charges on the Left Side Menu, select the Post Charge button.
- 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.
- The TPL information displays on the paper (HCFA) Claim and on the Electronic Claim in ANSI Loop 2330B.