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Third Party Liability

Coordination of Benefits:
Forms:
DCH-0402 , DCH-1354  DCH-0078 , and  DCH-0079   - PDF Documents
DCH-0402  DCH-1354 DCH-0078 , and  DCH-0079   - Word Documents


Carrier ID listing:  
By Carrier Name    Excel Spreadsheet

Values and Description of OI Codes:   Other Insurance Codes

JUST ASK - Coordination of Benefits Poster

Statutes:
Title XIX Section 1902(a)(25) of the Social Security Act
Assignment of Rights

Public Act 593 became effective Jan. 1, 2007 and provides for the sharing of health care coverage information with the Department of Community Health.  In addition, claims submitted within three years of the date of service shall not be denied based on the date of submission.


Casualty:
DCH-1354-A - PDF
Document
DCH-1354-A - Word
Document

 

Related Links:
Centers for Medicare and Medicaid Services (CMS)
Social Security Act

Michigan Compiled Laws/Public Acts

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