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Technical Interface Guidelines

Behavioral Health Interface

Third Party Liability (TPL) File
In this section The Third Party Liability (TPL) process identifies:
  • Verified TPL data received from and updated by our TPL contractor
  • Invalid TPL notifications

TPL referral data is received from many different sources including Health Plans, eligibility sources (DES, SSA, etc) and our TPL contractor. The referrals are processed through a validation process and we receive updates to the referrals that either verify TPL data or invalidate referrals. In addition to the TPL verifications, Medicare data is also provided on the daily files.
 
Schedules The following table outlines schedules for the Third Party Liability process.
 

Processing requirement

Schedule
The TPL file processing is performed seven days a week with the TPL Verification Contractor.
The Medicare data update process is performed on several different schedules including daily, semi-monthly, and monthly.
TPL Daily Verified data files

are downloaded to the AHCCCS Communications Server, verified, and available for extraction by the BHS by 7:00 a.m. the next day.

File is named yymmdd.TPL (daily file) and is available in the BHS folder under  /AZ/BHS/PROD/OUT folder and will contain both TPL and Medicare data
TPL Notification data file contain invalid TPL referrals that are downloaded to the AHCCCS Communications Server and are available for extraction by BHS by 7:00 a.m. the next day.

File is named yymmdd.NOT (notification file) and is available in the BHS folder under  /AZ/BHS/PROD/OUT folder
TPL Verified data Monthly file

contain verified TPL data that are downloaded to the AHCCCS Communications Server based upon the membership as of the first of the month and available for extraction by the BHS.

File is named ccyymm.TPL and is available in the BHS folder under  /AZ/BHS/PROD/OUT folder and will contain only TPL data.
Annual TPL Verified data file contains TPL data for any BHS covered segment in the past three years and are downloaded to the AHCCCS Communications Server.

File is named ccyymm.TPL and is available in the BHS folder under  /AZ/BHS/PROD/OUT folder and will contain only TPL data.
Master Carrier ID file

are downloaded to the AHCCCS Communications Server each Friday and available for extraction by the BHS by 7:00 a.m. the next day.

File is named RFCARIDmmddyy.TXT and is available in the ShareINFO folder under /AZ/ShareINFO/Reference/PROD/OUT folder.

 
Media The TPL File is available on the AHCCCS communications server.
 
Reference documents
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