Get Medicaid Reclamation

third party liability in Insurance Third party liability is insurance against money which an insured may have to pay to third parties if they accidentally cause them injury, loss, or damage. Travel agencies must carry third party liability coverage against damage caused to their customers and service providers.

The most common type of third-party insurance claim is a liability claim. For example, if you cause an accident on the freeway and injure a passenger in the other vehicle, that passenger can be a third party who can file a claim against your insurance company.

In most cases, Medicaid acts as the payer of last resort for most services. Under the program's third-party liability (TPL) rules, other legally responsible sources are generally required to pay for medical costs incurred by a beneficiary before the Medicaid program will do so.

Organization, public or private, that pays or insures medical expenses on behalf of enrollees. An individual pays a premium, and the payer organization pays providers' actual medical bills on the individual's behalf.

In most cases, Medicaid acts as the payer of last resort for most services. Under the program's third-party liability (TPL) rules, other legally responsible sources are generally required to pay for medical costs incurred by a beneficiary before the Medicaid program will do so.

DEFINITION: A Medicaid reclamation claim is a claim that is submitted by a Medicaid agency to another payer when it has been identified that the patient also has private insurance. Because the Medicaid agency paid the claim, it submits the claim to the private insurance for payment.

Third-party insurance covers an individual or firm against a loss caused by some third party. An example is automobile insurance that will indemnify the insured if another driver causes damage to the insured's car. The two main categories of third-party insurance are liability coverage and property damage coverage.

1) The Indiana Medicaid Third Party Liability (TPL) program establishes coordination of benefit rules designed to ensure that Medicaid is the payer of last resort, unless otherwise required. The claims payment system will apply edits that facilitate appropriate cost avoidance/coordination of benefit activities.