Third Party Liability

MEDICAID IMPROPER PAYMENTS $50.3 BILLION SYRTIS SOLUTIONS CMS FACT SHEET

31 Jan MEDICAID’S STRUGGLE WITH POOR QUALITY DATA

Medicaid currently fails at providing a system that efficiently and accurately stores and utilizes member data. As Medicaid is a joint state and federally run program, there are many problems with coordinating data platforms. Different states have their own unique data processing and storing, and...

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COB MEDICAID TPL OHI SYRTIS SOLUTIONS

27 Oct IDENTIFYING TPL IN THE MEDICAID PROGRAM

The vast majority of Medicaid improper payments occur due to antiquated data systems that result in eligibility errors. As the program has grown, identifying primary commercial coverage, also known as Third Party Liability (TPL), has become increasingly more complex and challenging. By law, Medicaid plans...

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20 Sep Medicaid Third Party Liability Report From GAO

Identifying third party liability continues to be a challenge under the coordination of benefits for Medicaid plans. By law, plans are payers of last resort so whenever beneficiaries have other active coverage (OHI), those third parties should pay first. Currently, Medicaid plans are required to...

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