How to Update Third Party Liability Information

For Providers or Caseworkers

Just Ask Medicaid Beneficiaries for their other insurance information and verify coverage at every visit.
Medicaid will need the following information regarding private health insurance (most of this information is located on the Health Insurance card):

• Name and phone number (if known) of the Insurance Carrier
• Policy holders name and birthdate (if known)
• Policy Number
• Group Number
• Start and end date of coverage (if known)

All providers will need to contact Third Party Liability (TPL) to report any changes (including new coverage or terminations) in other insurance information PRIOR TO SUBMITTING A CLAIM TO MEDICAID.

• Please submit all requests to TPL by completing the on-line DCH-0078 form or fax the completed form along with any supporting documentation to 517-346-9817. All requests should be processed by TPL within 7-10 business days. After the information has been updated, the claim can then be submitted with the appropriate other insurance information reported. This process will avoid unnecessary suspended claims as the other insurance information has been properly updated in CHAMPS.

• You may also contact 1-800-292-2550. Please contact this number if you have any immediate requests that involve member access to care. 

For Medicaid Clients/Beneficiaries

• Please submit all insurance requests to TPL by completed the on-line DCH-0078 form and uploading any supporting documentation or fax the completed form along with any supporting documentation to 517-346-9817. All requests should be processed by TPL within 7-10 business days.
• Insurance information can also be given to your primary care physician.
• If you have any questions, please contact the Beneficiary Hotline at 1-800-642-3195.