Third Party Liability Billing

Third Party Liability (TPL) projects are conducted by numerous states, providing Medicaid programs a mechanism to recoup payments rendered to home health providers for dually eligible patients. Agencies are required to review the appropriateness of billing and either submit a claim or demand bill to Medicare. If all demand bills are not submitted to Medicare within the project timeframe, Medicaid can recoup their payments for these patients, regardless of their skilled needs or homebound status.

 BlackTree can assist agencies in completing a portion of or the entire TPL project billing requirements. When the initial patient list is provided by the TPL contractor, BlackTree can create the database of episodes to be billed, obtain the necessary billing requirements from the agency software system, bill the claims to Medicare and track the progress of each billed claim. Based on agency needs, BlackTree is able to perform necessary billing functions manually through direct data entry into the Medicare system or through the agency’s software system. BlackTree can guide you through the TPL process and help you retain the reimbursement to which you are entitled.