Third Party Liability Data Match Overview

Facilitate correct and timely claim payments

To ensure that the correct payer is invoiced for services, the Ingenix Third Party Liability Data Match service compares a state’s Medicaid enrollment roster to other insurer’s (i.e. commercial payers, Medicare, PBMs, MCOs, Medicaid MCOs, etc.) to prevent Medicaid from paying twice for the same individual and paying future claims when other insurance is available.

In the event that other primary insurance exists, Medicaid’s enrollment roster is updated with the correct orders of liability to facilitate accurate claims payment.

These features, combined with real-time validation, help states:

• Proactively identify the correct payer
• Reduce dependence on pay-and-chase methodologies
• Support appropriate payments