Third Party Liability Division Commercial Coverage

Medical Billing

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The Michigan Department of Health and Human Services (MDHHS) Third Party Liability Division (TPL) partners with commercial health insurance companies to receive their coverage information. This information is directly verified with their official eligibility source. Each insurance company assures that policies in CHAMPS are reported exactly as they are needed to submit claims.

The insurance companies who currently report coverage directly to TPL include BCN, BCBSM, McLaren, Priority Health, Administration Systems Research, Physician’s Health Plan, Medimpact, Express Scripts, OptumRX and Delta Dental. TPL will not change the format of policy information for these payers. Please do not submit this type of request, including the following examples:

  • Adding or removing the alpha prefix for BCBSM coverage or other insurance companies
  • Terminating McLaren coverage based on the legacy system web portal when it is continuing on the new system web portal
  • Adding or removing hyphens and/or leading 0s from group numbers or policy numbers for Delta Dental, ASR, EHIM or other insurance companies

If providers determine coverage is being reported incorrectly by these insurance companies, please contact them to update their records. If the insurance company makes corrections, they will also send the update to TPL.

Source: Michigan Department of Health and Human Services

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