Third-Party Liability

Third-Party Liability/Coordination of Benefits (TPL/COB)

Georgia Medicaid members who have private health insurance coverage may contact their local county Division of Family and Children Services (DFCS) to provide any new or updated information concerning their health insurance coverage. Examples of an update to report include a change in your private insurance (new or existing coverage), termination of coverage, or the addition or removal of  a member(s).

You should Download this pdf file. complete the DMA-285 form for any updates or new insurance information that you need to report. Please submit the information by using one of the following methods:

You may contact the TPL/COB Unit at Gainwell Technologies for immediate updates at:  

Phone: 678-564-1162, Press 3
Fax: 770-980-0180
Email: [email protected]

Georgia Department of Community Health
100 Crescent Centre Parkway
Tucker, GA 30084

Or Division of Family and Children Services (DFCS)
Georgia Gateway website: https://gateway.ga.gov/access/
DFCS Contact number: 1-877-423-4746

If the member is covered by one of the CMOs, and the TPL record needs to be updated, please send those insurance update requests to the TPL Unit to coordinate the verification with the appropriate CMO Plan and update GAMMIS at TPL.InsuranceUpdates@dch,ga.gov.

Third-Party Liability - Related Links

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    Georgia Medicaid’s Subrogation, Estate Recovery and Special Needs Trust programs are administered by Health Management System (HMS). The Department of Community Health (DCH) oversees the administration of Georgia’s Medicaid and PeachCare for Kids® programs. HMS contracts with DCH to operate the Subrogation Unit, Estate Recovery Unit and Trust Unit.

  • Medicaid Estate Recovery

    Estate recovery is a program, required by federal law, whereby Medicaid members with qualified assets reimburse the taxpayers for long term care and home and community-based services provided through Medicaid.

  • Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

    Georgia Medicaid members may be eligible for the CHIPRA Premium Assistance Program if they are 19 years of age or younger and have access to their or their parent’s employer group health plan and those whose employers contribute at least 40 percent towards the cost of the premium.

  • Health Insurance Premium Payment Program (HIPP)

    Georgia Medicaid members who work may be eligible for premium assistance through a Medicaid program called the Health Insurance Premium Payment Program (HIPP).

  • Third-Party Liability Services Procurement

    The State of Georgia (Lead State), Department of Administrative Services (DOAS), State Purchasing Division (SPD) is requesting proposals for Third Party Liability Services (TPL) in furtherance of the NASPO ValuePoint Cooperative Purchasing Program.

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    The objective of the Program Integrity Utilization Review program is to identify and recover payments made to Medicaid providers that do not meet state and federal requirements. Audits, include coding validation, payment accuracy, compliance with state and federal regulations, policies, contractual requirements, and utilization standards.