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Third Party Liability Portal – Third Party Referral Module (IB25-01)

Date: 01/09/25

Louisiana Healthcare Connections is sharing with providers an update to the third party liability port. (IB25-01)

Effective December 16, 2024, the Louisiana Department of Health/Gainwell TechnologiesHealth Management Systems Third Party Liability Portal (LDH GWT-HMS TPL Portal) was enhanced with Third Party Referral (TPR) component functionality. This new TPR component added significant features to the current self-service options available to both providers and state partners (such as managed care entities) by allowing authorized users the ability to:

  1. Submit a new lead request. 
  2. Submit a reverification request. 
  3. Track the status of submitted new lead and verification requests.

This functionality provides greater transparency, more efficient submission of new lead and reverification requests, and an at-a-glance view of the status of submitted requests. New lead and reverification requests submitted have a five-business-day turnaround time and are considered routine, non-escalation requests.

The TPR component should not be used to submit escalation requests associated with immediate need for access to care or pharmacy awaiting since they have a four-business-hour turnaround time.. The TPR component also should not be used for updating scope of coverage (SOC) 01 (major medical) to 27 (major medical without maternity benefits) on an existing policy through reverification requests, or for adding a policy with a SOC of 27 (major medical without maternity benefits) through a new lead request. For these items, users should continue completing a “Louisiana Department of Health – Medicaid Recipient Insurance Information Update” form.

For escalations, submit the completed form to latprescalations@gainwelltechnologies.com or
by fax to 877-204-1325.

Support
For additional information including the access to the TPR component of the TPL portal, please refer to the updated user manual available here: TPL Portal User Manual for Providers and
Partners.

For questions, contact the LDH TPL Unit at (225) 342-4510 or by email at tpl.inquiries@la.gov.

Providers can review the complete bulletin for additional information.