How to Clear TPL Edits

Instructions for clearing Third Party Liability Edits

Agency View – HEALTH INSURANCE

Instructions for the Health Insurance Tab in Agency View

NON-PS2 Instructions (TPL)

This is a list with descriptions of the non-PS2 fields in the FACS TPL Tab.

PS2 Instructions – Section H (Third Party Liability)

This is a list with descriptions of each Section H field in IMS.

How to Code Third Party Liability (TPL)

Information regarding Third Party Liability (TPL) needs to be coded on the TPL tab in FACS so that the Oklahoma Health Care Authority (OHCA) can make sure the private insurance covers their part before OHCA pays anything on a bill. Make a copy of the insurance card so the information from that card can be […]

Third Party

Third party – a third party is someone other than the client or a member of the household.  A third party may make payments for a client, be responsible for medical claims, be a collateral contact, or report information about the client.  The client may also receive payments for a third party or make payments […]

Insurance

Insurance – examples of insurance include life, health, dental, vision, accidental death and dismemberment, and insurance for dependents.  Life insurance policies with a cash value are considered as resources for SoonerCare (Medicaid) and TANF.  When a person receives SoonerCare (Medicaid) and has medical insurance, the insurance is the first payer of medical claims.  When an […]

Third-Party Liability (TPL)

Medicaid applicants must disclose to OHCA any resources available to pay for care. This includes private insurance, government benefits (such as Medicare, CHAMPUS or TriCare) and worker’s compensation. All disclosed insurance policies must be entered on the TPL tab in FACS, except for Medicare which should not be entered but should be noted in FACS case […]