What is Third Party Liability (TPL) and what happens if an SCHIP child is covered by another health insurance program?
Third-Party Liability occurs when an individual is covered by two different insurance plans. For example, a person may have medical coverage through their employer and through Medicaid. When this happens the two insurers (i.e., the private company and Medicaid) need to coordinate payment for covered services. The Health and Recovery Services Administration is required by federal regulation to determine the liability of third-party resources that are available to its clients. All resources available to the client that are applicable to the costs of medical care must be used. Once the applicable resources are applied, HRSA may make payment on the balance if the third party payment is less than the allowed amount. To be eligible for HRSA programs, a client must sign his/her insurance rights to the state in conformance with federal requirements.
Related Questions
- What happens if the problem is caused by equipment not covered by the ServiceNOW™ program, or by a third party vendor such as the T1 service provider?
- What is Third Party Liability (TPL) and what happens if an SCHIP child is covered by another health insurance program?
- Can My Child be covered by Children’s Health Insurance Program?
