After the FCRC reports the TPL resource in the 2nd, 3rd, and 4th positions, the TPL Section enters a letter in the first position when a third party resource is verified and the extent of the coverage is determined. Do not change these codes.

NOTE: If the TPL resource has not changed, reenter this code when resuming a suspended case. If the TPL resource has changed, wait until the TPL Section reassigns a new code.

TPL COVERAGE CODE DESCRIPTION PAYS FOR ALL OR PART OF THESE SERVICES
A Comprehensive Health Insurance (Level 1) Inpatient/Outpatient Hospital, Clinic, Physician, Podiatrist, Laboratory, Transportation, Long Term Care, Dental, Optometrist
B Comprehensive Health Insurance (Level 2) Inpatient/Outpatient Hospital, Clinic, Physician, Podiatrist, Laboratory, Transportation, Long Term Care, Dental
C Comprehensive Health Insurance (Level 3) Inpatient/Outpatient Hospital, Clinic, Physician, Podiatrist, Laboratory, Transportation
D Basic Benefits and Major Medical Inpatient/Outpatient Hospital, Physician, Podiatrist, Laboratory, Transportation
E Basic Benefits Inpatient/Outpatient Hospital, Physician
F and G Hospitalization - Inpatient/Outpatient Levels 1 (F) and 2 (G) Inpatient/Outpatient (Coverage code F provides more coverage than code G.)
H and I Limited and Indemnity Policies Accident Only, Cancer Only, etc.