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TPL Helpful Hints<br />
• When to use the TPL Lead Form:<br />
• When there is no response within 120 days from the insurance<br />
carrier.<br />
When the other health insurance has not responded to a provider’s<br />
billing within 120 days from the date of filing a claim, a provider may<br />
<strong>com</strong>plete a TPL Lead Form.<br />
Mark “no response in 120 days” on the TPL Lead Form.<br />
Attach it to the back of claim and submit it to EDS.<br />
EDS overrides the other health insurance edits and forwards a copy of<br />
the TPL Lead form to the TPL Unit. The TPL staff contacts the<br />
insurance carrier to see why they have not paid their portion of liability.<br />
• Used for Commercial Insurance Only<br />
• Not to be used for Medicare<br />
• Other section is obsolete<br />
• Contact name and phone number is person and phone<br />
number at Commercial Insurance<br />
Cabinet for Health and Family Services<br />
17
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