Topic: TPL
Instructions for clearing Third Party Liability Edits
Instructions for the Health Insurance Tab in Agency View
This is a list with descriptions of each Section D field in IMS.
This is a list with descriptions of each Section H field in IMS.
Oklahoma Long Term Care Partnership (LTCP) Program is a policy purchased after 2008 and will have statement on the face page of the qualification from Oklahoma Insurance Department. The policy must be exhausted before client can become eligible for SoonerCare. Having this policy allows the amount of face value of the policy to be protected […]
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 – 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 – 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 […]
LTC Insurance should be coded in the TPL section in FACS. Payments are not considered income and nursing facility needs to become payee of the benefits Send an email to TPL@okhca.org as soon as possible with the name, phone number and address of the facility along with client information Client’s vendor payment is not affected […]