Third-Party Liability (Visual Book)

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Third Party Liability: The Visual Medicaid Basics Book

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Payer of last Resort • Cost Avoidance • Check Eligibility • TPL Coverage Sources

Sequential Billing • Dually Eligible Sequence • Health Insurance Information Referral Form (HIIRF)

Research of Documentation • Required TPL Claim Information • Carrier Codes • Policy Numbers

Required CMS-1500 TPL Claim Information • UB-04 TPL Claim Information • Reporting TPL on the Web Tool

How to Calculate TPL Payments • Professional Claim Example • CMS-1500 Calculation Examples

UB-04 Medicare Claims Calculation • UB-04 Calculation Examples • Timely Filing • TPL Edits

Edit Code Description and Resolution • UB04 ECF Example • Reasonable Effort

Reasonable Effort Documentation Form • Retroactive Recovery • Pay and Chase • Voluntary Refunds

Refunding by Check • Refund by Void/Replacement • Solicited Refunds • Retroactive Recovery Letters

Retro Medicare Provider Letter • Retro Health Initial Letter • Retro Health Final Letter • SCDHHS and TPL

MIVS and TPL • Health Insurance Premium Payment (HIPP)