Adding/Updating Private Insurance Information Using the TPL-1 Form

A Participant reports insurance has ended – Updating

Step 1

Log into FAPC and clear your screen. Type MTPR, space, 8 digit DCN. Use this screen to determine if an updated TPL-1 is needed.

**NOTE: If there is an urgent medical need such as someone needing to pick up a prescription or attend a doctor appointment, FSD staff may contact the TPL Unit by phone, 573-751-2005 or email mhd.costrecovery@dss.mo.gov. When emailing, make sure to include the recipient’s name, social security number, the name of the insurance that needs to be ended, and the reason for urgency. Ensure this information is entered in the body of the email; not the subject line.**

If this is not urgent and the insurance reported as ended still displays active on the MTPR screen, follow the remaining steps.

Step 2

Locate and open the TPL-1 form and instructions in the IM Forms Manual

Step 3

Use participant’s information found in FAMIS/MEDES, the MTPR screen, along with the TPL-1 instructions, to complete page 1 of TPL-1 form.

Step 4

On page 2 of the TPL-1 form, use the box labeled “additional information” to add additional information; such as when the insurance ended.

Step 5

Email the completed form to tpl.database@dss.mo.gov

Step 6

Make any FAMIS/MEDES entries needed to end the insurance information

A Recipient reports new insurance – Adding

Step 1

Before adding the new insurance, use step 1 above (MTPR screen) to determine if a prior insurance needs to be ended. If yes, complete a separate TPL-1 form to end the old insurance.

Step 2

Locate and open the TPL-1 form and instructions in the IM Forms Manual and complete all necessary fields.

Step 3

Make all needed FAMIS/MEDES entries needed to record the new insurance

Step 4

If more information is needed to complete the TPL-1 form and entries in FAMIS/MEDES, send an FA325 Request for Information or IM-31A to the participant.

If the TPL-1 form is complete, email it to tpl.database@dss.mo.gov