Add New TPL Policy

1. Logon to C1 and select Function 2 – ‘Medicaid Third Party Liability’. Click  ENTER.
2. Select Function 1, ‘Health Insurance/Medical Liability’ from TPL Subsystem Menu. Click  ENTER.
3. On the Case Activity Screen, enter ‘S’ (for Search) under the Action Code. Directly under ‘Action Code’, enter the Master Case Number. Press ENTER (the SSN, Medicaid number and other fields on this window do not need to have data entered).

4. The Search Reply screen will display all persons in the Master Case. Any insurance information that was previously entered will appear under their name. Enter an ‘X’ under the heading ‘ACT’ for each person for whom you need to enter data for this health insurance policy. All persons selected must have the same 9 digit MMIS number.  When all persons have been selected, click ENTER.

   Note: If the only person eligible for Medicaid is a child or unborn, enter the X in front of their name. The parent would be listed as the Policy Holder in step 8. See 477 NAC 18-003, Step 4 returns you to the Case Activity Screen. The Medicaid Number and numeric ID number are displayed for each person selected.

5. Enter ‘A’ (for Add) in the Action Code, TAB DOWN to ‘Last Name’ field. Enter the insurance company name. Click ENTER.

   Note:  This field is used for multiple name searches including a search for the name of the insurance company.  Use it to search by name of a Master Case Person, a policyholder, or the insurance company.

6. After pressing the ENTER key, a message displays at the bottom of the screen: “Press F4 for Carrier Name Search”. Pressing F4 will take you to the window displaying the matches for the carrier name that you entered. Enter an ‘S’ under the Heading ‘ACT’ by the carrier that matches the one you are entering. ENTER to return the Carrier Code to the Case Activity Screen.

   Note:  If you see a message that say “No Carrier Found” exit the window and start from Step 2 to attempt another search by a different carrier name

7. Upon return to the Case Activity Screen, the carrier code is displayed along with a message at the bottom of the screen that says “press enter to continue”. Then ENTER.
8. Enter the following mandatory information on the Health Insurance/Medical Liability screen:
   1. Policyholder first and last name

   2. Policyholder SSN

      Note: 

      If known, the correct SSN should always be used. If not known, leave the field blank until all other information is entered.

      After everything else has been entered, press ENTER. An error message will appear at the bottom of the screen instructing you to either complete the SSN field or press F11 to generate an SSN if the SSN is not known.

      Select the F11 key on your keyboard. Then ENTER.

      Result: Inserts random number (begins with a ‘G’)

   3. Information Source Code (‘01’ for caseworker)
   4. Policy number (no spaces or special characters)
   5. Coverage Verification Code
   6. Premium Payer Code
   7. Relationship to Policyholder Code
   8. Coverage Type Code
   9. Coverage From Date
9. After adding the information from step 8,  press ENTER. A message will appear at the bottom indicating the Medicaid ID# of the person that was added.
10. The next person to be added will appear at the top of the screen. Complete ONLY the blank fields to update the next person. When all persons have been successfully entered, you will be returned to the Case Activity Screen with the message ‘Records added’.
11. Select F3 to ‘QUIT’.

Note: Use the F1 key on your keyboard for HELP for a specific field.  Place the cursor in the field for which you need help, and press the F1 key on your keyboard.

(01-2014)