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TMSIS Dataguide Medicaid.gov
Version 3.28.0

TPL-MEDICAID-ELIGIBLE-PERSON-MAIN

File Segment

File Segment Number

TPL00002

File Name

TPL - THIRD-PARTY LIABILITY

Last updated

No Updates

Data Elements Reference
DE Number System DE Number Data Element Definition Valid Values
TPL016 TPL.002.016 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.). TPL016 Values
TPL017 TPL.002.017 SUBMITTING-STATE A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. TPL017 Values
TPL018 TPL.002.018 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
TPL019 TPL.002.019 MSIS-IDENTIFICATION-NUM

A state-assigned unique identification number used to identify a Medicaid/CHIP enrolled individual (except on service tracking payments). Value may be an SSN, temporary SSN or State-assigned eligible individual identifier. MSIS Identification Numbers are a unique "key" value used to maintain referential integrity of data distributed over multiples files, segments and reporting periods. See T-MSIS Guidance Document, "CMS Guidance: Reporting Shared MSIS Identification Numbers" for information on reporting the MSIS Identification Numbers ID for pregnant women, unborn children, mothers, and their deemed newborns younger than 1 year of age who share the same MSIS Identification Number. https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47572

 N/A
TPL020 TPL.002.020 TPL-HEALTH-INSURANCE-COVERAGE-IND

A flag to indicate that the Medicaid/CHIP eligible person has some form of third party insurance coverage.

 TPL020 Values
TPL021 TPL.002.021 TPL-OTHER-COVERAGE-IND A flag to indicate that the Medicaid/CHIP eligible person has some other form of third party funding besides insurance coverage. TPL021 Values
TPL022 TPL.002.022 ELIGIBLE-FIRST-NAME The first name of the individual to whom the services were provided. N/A
TPL023 TPL.002.023 ELIGIBLE-MIDDLE-INIT Individual's middle initial; middle initial component of full name (e.g. First Name, Middle Initial, Last Name). N/A
TPL024 TPL.002.024 ELIGIBLE-LAST-NAME The last name of the individual to whom the services were provided. N/A
TPL025 TPL.002.025 ELIG-PRSN-MAIN-EFF-DATE The first calendar day on which all of the other data elements in the same segment were effective. N/A
TPL026 TPL.002.026 ELIG-PRSN-MAIN-END-DATE The last calendar day on which all of the other data elements in the same segment were effective. N/A
TPL027 TPL.002.027 STATE-NOTATION

A free text field for the submitting state to enter whatever information it chooses.

 N/A
Definition
A record to capture basic, generally static information to identify Medicaid/CHIP enrollees for whom third party funds may be available to offset some or all of their Medicaid/CHIP costs.

File Segment Length
900