Third Party Liability – Other Health Insurance

This page is completed if the child has health insurance through a parent.  Medical claims is sent through this insurance prior to billing Medicaid.  Complete this page based on information provided by the parent.

1. Click Other Health Insurance link.  The Third Party Liability – Other Health Insurance List displays.

2. Click the Add button.  The TPL – Other Health Insurance Detail page displays.

3. Select the child’s name from the Beneficiary drop-down menu.

4. Select one of the following:  Other Health Coverage, Employer Family Health Coverage or Healthy Families Only from the Health Coverage Type drop-down menu.

5. Enter Start Date using the <mm/dd/yyyy> format or the calendar icon.

6. Complete known Health Insurance Information:

   • Health Insurance Company Name

   • Policy Number

   • Group Number

   • Type of Coverage

   • Type of Insurance

   • Name of Plan

   • Address, City, State and Zip Code

7. Complete known Policy Holder Information:

   • Policy Holder Name

   • Policy Holder Social Security

   • Select the child’s name from the Who is Covered drop-down menu (required field)

   • Complete other fields if information is available

8. Complete Access to Health Insurance, if available.

9. Select Verified from the Verified drop-down menu.

10. Click the Save and Return button.  

    NOTE:  KEES automatically transmits this information to the MMIS.

11. Proceed to PPS Eligibility Determination and Benefit Calculation.