Minn. R. 9505.0070, Minn. R. 9505.0071 and Minn. R. 9505.0440

MHCP dual eligible: Recipients enrolled in Minnesota Health Care Programs and eligible for Medicare or other third party insurance benefit.

Third party liability (TPL): Health, long-term care or dental insurance coverage a Minnesota Health Care Programs recipient may have through private or public funds.

MHCP considers Medicare and TPL primary to MHCP coverage. Providers must bill and receive payment from Medicare and all third party insurance benefits to the fullest extent possible before billing MHCP.

Lead agencies and/or providers are responsible to:

1. Verify eligibility through MN–ITS for MHCP and/or Medicare and other third party insurance coverage.
2. Determine if Medicare or other third party insurance may pay for home care, waiver services, medical equipment or supplies.
3. Complete authorization and billing through the policies of Medicare or other insurances before: