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TMSIS Dataguide Medicaid.gov
Version 3.36.0

TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES

File Segment

File Segment Number

TPL00004

File Name

TPL - THIRD-PARTY LIABILITY

Last updated

No Updates

Data Elements Reference
DE Number System DE Number Data Element Definition Valid Values
TPL052 TPL.004.052 RECORD-ID The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.). TPL052 Values
TPL053 TPL.004.053 SUBMITTING-STATE A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. TPL053 Values
TPL054 TPL.004.054 RECORD-NUMBER A sequential number assigned by the submitter to identify each record segment row in the submission file. The Record Number, in conjunction with the Record Identifier, uniquely identifies a single record within the submission file. N/A
TPL055 TPL.004.055 INSURANCE-CARRIER-ID-NUM The state-assigned identification number of the Third Party Liability (TPL) Entity. N/A
TPL056 TPL.004.056 INSURANCE-PLAN-ID The ID number issued by the Insurance carrier providing third party liability insurance coverage to beneficiaries. Typically the Plan ID/Plan Number is on the beneficiarie's insurance card. N/A
TPL057 TPL.004.057 INSURANCE-PLAN-TYPE Code to classify the entity providing TPL coverage. TPL057 Values
TPL058 TPL.004.058 COVERAGE-TYPE Code indicating the level of coverage being provided under this policy for the insured by the TPL carrier. TPL058 Values
TPL059 TPL.004.059 INSURANCE-CATEGORIES-EFF-DATE The first calendar day on which all of the other data elements in the same segment were effective. N/A
TPL060 TPL.004.060 INSURANCE-CATEGORIES-END-DATE The last calendar day on which all of the other data elements in the same segment were effective. N/A
TPL061 TPL.004.061 STATE-NOTATION A free text field for the submitting state to enter whatever information it chooses. N/A
Definition
A record to capture TPL insurance coverage information to support the applicability assessment of the third party insurance coverage to the Medicaid/CHIP costs incurred on behalf of the Medicaid/CHIP enrollee.

File Segment Length
900