eMedNY TPL Overview The eMedNY Third Party Liability (TPL) - PowerPoint PPT Presentation

eMedNY

TPL Overview • The eMedNY Third Party Liability (TPL) application maintains comprehensive (current and historical) information to support cost avoidance performed by eMedNY and post- payment recovery function performed by the Third Party subsystem • This information is used to reduce Medicaid expenditures. Therefore, the TPL Subsystem ensures that Medicaid is the payer of last resort

TPL Overview, cont’d. • eMedNY TPL retains the following Third Party Resources:  Commercial Insurance  Medicare  Buy-In  Carrier  Health Insurance Premium Payments (HIPP)  Medicare Insurance Premium Payments (MIPP)

Resource Search (Inquiry)

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AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A

AB12345Z 123456789A

AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A AB12345Z 123456789A

AB12345Z 123456789A

Entering Medicare Part A & B

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BM31067Z 998877777A

BM31067Z 998877777A

BM31067Z 998877777A

BM31067Z 998877777A

BM31067Z 998877777A

BM31067Z 998877777A

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Entering MSP

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ZY54321A 987654321A

ZY54321A 987654321A

ZY54321A 987654321A

ZY54321A 987654321A

987654321A

ZY54321A 987654321A

Ending Medicare

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JK456789B AB12345Z 678901234A

AB12345Z JK456789B 678901234A

JK456789B AB12345Z 678901234A

AB12345Z JK456789B 678901234A

Voiding HC

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DM06296F AB12345Z 123456789A 654321987A

DM06296F 654321987A 654321987A

DM06296F 654321987A 654321987A

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Changing HIC Number

BM03016J BM03016J 112233445A BM03016J 112233445A BM03016J 112233445A BM03016J 112233445A

BM03016J 112233445A

BM03016J 112233445A 112233445A

BM03016J 112233445A 112233445A

BM03016J 112233445A

BM03016J 112233445A

BM03016J 889900112A 112233445A

BM03016J 889900112A 112233445A

BM03016J 889900112A 112233445A

End Dating Buy-In

KM12298A KM12298A 556611223A KM12298A 556611223A KM12298A 556611223A KM12298A 556611223A KM12298A 556611223A

KM12298A 556611223A 123456789A 556611223A

KM12298A 556611223A

KM12298A 556611223A

KM12298A 556611223A

Changing Buy-In Category

GM10112M GM10112M 334455667A GM10112M 334455667A GM10112M 334455667A GM10112M 334455667A

GM10112M 334455667A

GM10111M 334455667A

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Interpreting “Medicare Buy -In for Client” Screen

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445566998A

558899664A

Notes Tab Enter any necessary notes here!

Accessing MOBIUS Reports

Accessing Mobius Reports 2 1 3 4 5

Accessing Mobius Reports, cont'd. 6 7 8 To locate TPL Reports, enter # of specific report or “T” will bring you to the first TPL report

Accessing Mobius Reports, cont'd.

Cases Referred to LDSS by NYSOH Processing Instructions • Mary Houlihan or Kiera Campbell • Bureau of Third Party Liability – Phone: (518) 473-5330 – Fax: (518) 473-0601 October 2015

Medicare Insurance Premium Payments (MIPP) • Active NYSOH cases referred to the local district must be reviewed for existing Medicare Insurance Premium Payments (MIPP) • eMedNY Buy-in entries should never overlap with MIPP payments

• Go to Client Search • Click on the Third Party Tab

Click the blue hyperlink under the HIC under Policy/HIC No. 123459851a Next click the Payment Tab

• Click the Blue caret outlined in red to check for current paylines associated with the case. • Referral file cases may have a 4 month payline into the future.

• Issued payments will be displayed under “Completed Payments” section