Third party overview

A third party is set up when a payment needs to be sent to someone other than the provider or member. Direct deposit bank deposits can be made to the member using a third party ID number.

Access Third Party

There are a few ways to view and enter Third Party information from a member, dependent, or claim:

Search for and open a member or dependent.
Select Claims, and then select Third Party.

Search for and open a claim.
Select Patient, and then select Third Party.

To learn more about using this tab to add, update, or delete third party information, see Add, update or delete third party information.

Demographics tab

The Demographics tab is where you can enter and view the address, account, and the alternate member social security number.

Demographics Field Descriptions

Column	Description
Use Third Party	Determines if the Third Party address is used for claims assigned to the member. `Y`—Checks and Statements. `N`—No third party. `C`—Checks only. `S`—Statements only.
3rd Party Id	Unique Third Party ID number. This helps you identify the Third Party when batch checks are issued to the same Third Party for multiple members. If an ID number is used, the address, phone, and language for the Third Party updates and are read-only. This is useful if multiple claimants use the same third party.
Use for whole family	Check box that indicates the third party address is used for all dependents.
Routing Number	Nine-digit code based on the US. Bank location where the Member's account was opened. It's the first set of numbers printed on the bottom left of a check. You must enter a value or you can't save the Third Party Account Number or the Account Type.
Account Number	Member's account number. Used when batch checks are issued to a Third Party. You can only save this value if you select a Routing Number.
Account Type	Either `Checking` or `Savings` account.
Name
Last Name	The individual's last name.
First Name	The individual's first name.
Middle Name	The individual's middle name.
Prefix	A title that displays at the beginning of a person's name to indicate marital status and gender, education, or occupation, (e.g., Dr., Mrs., PhD, etc.)
Generation	Suffix to distinguish persons that share the same name in a family, (e.g. Jr., II, Sr, etc.)
Title	A professional or some other designation that comes at the end of a name, for example, CPA, MD, ESQ, etc.
Address
Country	Country of the Third Party. When entering an address for a country outside of the United States, a country code selection icon displays if you've configured the `Possibilities for Address Line 3` table on the `Country Codes` screen (see Manage Country Codes). For example, after selecting Germany as the Country for the mailing address, displays. The lines for the American address format (Apartment/Suite/Floor, Street Address or P.O. Box, and City, State, and Zip) also change to Address Line 1, 2, and 3. Select to view a list of address 3 options for the country entered. This example displays options for Germany. You can choose an option from this window to be the address line 3 information and click , or manually enter the address line 3 if needed or preferred. Note: doesn't display if you haven't configured options for the `Possibilities for Address Line 3` table on the `Country Codes` screen. Contact your administrator for more information.
Invalid Address	`Invalid Address`- Check box indicating the address isn't valid.
Address 1	The apartment, suite, floor, etc. This is the first line in the address that isn't a street address or PO box number.
Address 2	The street address or PO box information.
Address 3	The city, state, and ZIP code.
Additional Information
Phone	The individual's phone number.
Language	The individual's preferred language.
Audit Claimant	Select the `View Details` link to display the Claimant Audit screen.
Statements	Indicates if an Explanation Of Benefits (EOB EOBs are sent to members and payees to inform them of the disposition of claims. Typically an EOB identifies the date and type of service, the billed amount, deductibles, co-insurance, and an explanation of any ineligible charges. An EOB can also be a helpful tool in identifying fraudulent claims, as the member receives notification even when payment is made to the provider. An EOB isn't a bill.) statement should be sent to the member when a payment or an EOB EOBs are sent to members and payees to inform them of the disposition of claims. Typically an EOB identifies the date and type of service, the billed amount, deductibles, co-insurance, and an explanation of any ineligible charges. An EOB can also be a helpful tool in identifying fraudulent claims, as the member receives notification even when payment is made to the provider. An EOB isn't a bill. is sent to a third party. `N`—No Statement to Member. `Y`—Statement to Member and Third Party.
Alternate Member
Member	Alternate member number—Identifies the original member's social security number for a dependent who originally existed under another membership number. This allows for accurate linking of illness, admission, and disputed case data in addition to duplicate checking. This is also the link to accumulators stored under this alternate member or dependent. Note that you can't enter a member number of someone in the member's family, for example, a dependent.
Dependent	Dependent's sequence number under the original membership—This field is only available and required when you've entered a value in the Alternate Member field.

Address History tab

The Address History tab contains Third Party address history information including alternate or previous addresses, current address designation, and if an address is invalid.

Address History Field Descriptions

Column	Description
Address 1	First line of a historical alternate mailing address (for USA, apartment, suite, and floor).
Address 2	Second line of a historical alternate mailing address (for USA, street address or P.O. box).
Address 3	Third line of a historical alternate mailing address (for USA, street address or P.O. box).
Current	Radio button that indicates which address is the current address.
Action Date	Date when an address was entered, modified, or deleted.
Operator	User ID of the individual who entered, modified, or deleted the address information.
Invalid	Check box to indicate that an address is invalid.