MES Certification Navigator
TPL1

Application

CMS-required outcome

The system does the following: - Records third parties, - Determines the liability of third parties, - Avoids payment of third-party claims, - Recovers reimbursement from third parties after Medicaid claims payment, and - Records information and actions related to the plan.

Default metrics
  • Percentage of Medicaid beneficiaries with stored potential third party liability information.
  • Number of records of third-party liability reimbursements.
  • Amount of recovered dollars from reimbursements.
Regulatory sources

Other Third Party Liability outcomes