The Casualty Recovery Team works to coordinate benefit and collection practices with providers, members, and other insurance companies to ensure that Medicaid is the payer of last resort. The team is responsible for Medicare Part D casework including claims processing assistance, coverage verification, and issue resolution.
The Third Party Liability Team (TPL) works diligently to recover funds from third parties where Medicaid should not have been solely responsible. Those efforts include estate recovery, absent parent medical support recovery, casualty recovery, patient liability recovery, Medicare recovery, Medicare prescription recovery, special needs recovery, and trust recovery. The team has been able to increase TPL cost avoidance dollars, a direct result of ensuring that correct TPL insurance information is in the payment systems and being used appropriately.
Please note that in the Fall of 2020 these Teams (formerly known as the Coordination of Benefits (COB) Unit) and the Provider Member Relations (PMR) Unit merged and became the Member Provider Services (MPS) Unit. They are displayed separately in this scorecard due to their different lines of work.