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

▶
emedny tpl overview
SMART_READER_LITE
LIVE PREVIEW

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

Oct 13, 2022 18 likes •968 views

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

slide-1
SLIDE 1

eMedNY

slide-2
SLIDE 2

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

slide-3
SLIDE 3

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)

slide-4
SLIDE 4

Resource Search (Inquiry)

slide-5
SLIDE 5
slide-6
SLIDE 6
slide-7
SLIDE 7
slide-8
SLIDE 8
slide-9
SLIDE 9
slide-10
SLIDE 10
slide-11
SLIDE 11
slide-12
SLIDE 12
slide-13
SLIDE 13

AB12345Z 123456789A

slide-14
SLIDE 14

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

AB12345Z 123456789A

slide-15
SLIDE 15
slide-16
SLIDE 16
slide-17
SLIDE 17
slide-18
SLIDE 18
slide-19
SLIDE 19
slide-20
SLIDE 20

AB12345Z

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

123456789A

slide-21
SLIDE 21

AB12345Z

123456789A

slide-22
SLIDE 22

AB12345Z

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

123456789A

slide-23
SLIDE 23

AB12345Z

123456789A

slide-24
SLIDE 24

Entering Medicare Part A & B

slide-25
SLIDE 25
slide-26
SLIDE 26

BM31067Z

slide-27
SLIDE 27

BM31067Z

slide-28
SLIDE 28

BM31067Z

slide-29
SLIDE 29

BM31067Z

slide-30
SLIDE 30

BM31067Z

slide-31
SLIDE 31

998877777A

BM31067Z

slide-32
SLIDE 32

998877777A

BM31067Z

slide-33
SLIDE 33

998877777A

BM31067Z

slide-34
SLIDE 34

998877777A

BM31067Z

slide-35
SLIDE 35

998877777A

BM31067Z

slide-36
SLIDE 36

998877777A

BM31067Z

slide-37
SLIDE 37

998877777A

BM31067Z

slide-38
SLIDE 38

Entering MSP

slide-39
SLIDE 39

ZY54321A

slide-40
SLIDE 40

987654321A

ZY54321A

slide-41
SLIDE 41

987654321A

ZY54321A

slide-42
SLIDE 42

ZY54321A

987654321A

slide-43
SLIDE 43

ZY54321A

987654321A

slide-44
SLIDE 44

987654321A

ZY54321A

slide-45
SLIDE 45

987654321A

slide-46
SLIDE 46

987654321A

ZY54321A

slide-47
SLIDE 47

Ending Medicare

slide-48
SLIDE 48

JK456789B

slide-49
SLIDE 49

091287344 120934875 120934875001 678901234A 678901234A 678901234A 678901234A

JK456789B

JK456789B JK456789B JK456789B JK456789B JK456789B JK456789B JK456789B

slide-50
SLIDE 50

678901234A

AB12345Z

JK456789B

slide-51
SLIDE 51

678901234A

AB12345Z JK456789B

slide-52
SLIDE 52

678901234A

AB12345Z

JK456789B

slide-53
SLIDE 53

678901234A

AB12345Z

JK456789B

slide-54
SLIDE 54

Voiding HC

slide-55
SLIDE 55

DM06296F

DM06296F DM06296F DM06296F DM06296F 654321987A 654321987A 654321987A 654321987A

slide-56
SLIDE 56

123456789A 654321987A

AB12345Z

DM06296F

slide-57
SLIDE 57

654321987A 654321987A

DM06296F

slide-58
SLIDE 58

654321987A 654321987A

DM06296F

slide-59
SLIDE 59

654321987A

DM06296F

slide-60
SLIDE 60

Changing HIC Number

slide-61
SLIDE 61

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

BM03016J

slide-62
SLIDE 62

112233445A

BM03016J

slide-63
SLIDE 63

112233445A 112233445A

BM03016J

slide-64
SLIDE 64

112233445A 112233445A

BM03016J

slide-65
SLIDE 65

112233445A

BM03016J

slide-66
SLIDE 66

112233445A

BM03016J

slide-67
SLIDE 67

112233445A

BM03016J

889900112A

slide-68
SLIDE 68

889900112A 112233445A

BM03016J

slide-69
SLIDE 69

889900112A 112233445A

BM03016J

slide-70
SLIDE 70

End Dating Buy-In

slide-71
SLIDE 71

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

KM12298A

slide-72
SLIDE 72

556611223A 123456789A 556611223A

KM12298A

slide-73
SLIDE 73

556611223A

KM12298A

slide-74
SLIDE 74

556611223A

KM12298A

slide-75
SLIDE 75

556611223A

KM12298A

slide-76
SLIDE 76

Changing Buy-In Category

slide-77
SLIDE 77

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

GM10112M

slide-78
SLIDE 78

GM10112M

334455667A

slide-79
SLIDE 79

GM10111M

334455667A

slide-80
SLIDE 80

334455667A

slide-81
SLIDE 81

Interpreting “Medicare Buy-In for Client” Screen

slide-82
SLIDE 82

885522336A

slide-83
SLIDE 83

445566998A

slide-84
SLIDE 84

558899664A

slide-85
SLIDE 85

Notes Tab

Enter any necessary notes here!

slide-86
SLIDE 86

Accessing MOBIUS Reports

slide-87
SLIDE 87

Accessing Mobius Reports

1 2 3 4 5

slide-88
SLIDE 88

Accessing Mobius Reports, cont'd.

To locate TPL Reports, enter # of specific report or “T” will bring you to the first TPL report 6 8 7

slide-89
SLIDE 89

Accessing Mobius Reports, cont'd.

slide-90
SLIDE 90

October 2015

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

slide-91
SLIDE 91

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
  • verlap with MIPP payments
slide-92
SLIDE 92
  • Go to Client Search
  • Click on the Third Party Tab
slide-93
SLIDE 93

123459851a

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

slide-94
SLIDE 94
  • 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.

slide-95
SLIDE 95
  • Issued payments will be displayed under

“Completed Payments” section