Summit can output large volumes of data, files, and reports through Data Exchange to support your administrative needs. In addition to exporting data on demand, Summit allows you to schedule data exports. One of the key tools in Data Exchange is the ability to create and manage a wide range of schedules. You can associate different reports and data … Read More >>
Summit can produce files that are made available to TPAs on the File Fulfillment page. These files can be manually downloaded and sent to the TPA’s bank (e.g., Check/ACH files) for processing and participant reimbursement. The objective of DataPath File Fulfillment is to provide TPAs with a way to utilize DataPath’s banking partner for the automated processing of files—eliminating the need for manual … Read More >>
The Process Approvals section allows the user to view, approve, or reject various processes that require manual approval. These include ACH Returns, Contributions, Document Fulfillment, Election Changes, Events, Missing Information, Partner Messages, Premium Auto-Drafts, Online Enrollments, Reimbursements, Remittances, and Unapplied Receipts. * Required fields appear in Red To access Process Approvals, Process Approvals The Process Approvals screen displays … Read More >>
The Transaction Entry screen of Summit’s Processing module allows the user to enter a wide variety of transactions pertaining to a participant’s benefit plans or accounts. This screen will be disabled and hidden for Premium Billing-only TPAs. If the user is a CDH+PB TPA user with access to this screen, no transactions may be entered … Read More >>
The Transaction Review section allows users to review and approve or deny transactions that have been manually entered or created via debit card swipes. Additionally, users can review documentation that has been uploaded to substantiate claims and assign images sent via Summit Zip-Line™ to claims. This screen will be disabled and hidden for Premium Billing-only TPAs. To … Read More >>
The Transaction Search tab provides users with a centralized view of transactions and a set of search filters to review transaction sets that meet their criteria. To access Transaction Search, Transaction Search The Transaction Search page consists of three sections: Employer –This is a dropdown list that auto-populates with all employers present under the TPA. Users must select an … Read More >>
The Reporting module of Summit provides users with access to CDH and Premium Billing reporting tools, Nondiscrimination Testing and reporting, Plan Document creation, and MSP Reporting. The Reporting module allows users to extract Summit data to create human-readable reports and documentation using customizable templates. For more information on the customization of report templates, see the … Read More >>
The Create Plan Documents screen is where the user will go when it is time to generate and send a plan document to the employer. To access Create Plan Documents, The Create Plan Document Page will display some parameters as shown below. Create Plan Documents Parameters TPA – From this dropdown list, the user can … Read More >>
The Plan Document Templates Page is a place where the TPA user will come to set up a template document or make sure that an employer is assigned to the correct template document. To access Plan Document Templates, The Plan Document Templates Page will display some parameters as shown below. Plan Document Templates Parameters TPA … Read More >>
The Reports page of Summit’s Reporting module allows users to view and run reports on demand. To access the Reports page, This will take you to a page listing all reports available to the user for the TPA. Reports available to the user will list alphabetically. By default, 10 report formats will list per page. … Read More >>
Summit users can easily manage plan documents for employers by being able to see all the required merge fields, review the data that is populated in the core system for those fields, and manually enter data that is specific to plan documents and not captured elsewhere in the system. The user will be able to … Read More >>
Summit allows the user for gathering employer data related to plan documents. Once the user is in the Plan Documents module, the ER Data screen can be accessed via a link on the right-hand side of the page. It allows the user to review and manually enter Employer Plan Document data, streamlining much of the … Read More >>
* Required fields appear in Red The Administrator Settings | Administrator Central page is a central hub for data and settings that pertain to your TPA entity. This page contains your TPA basic demographics, as well as advanced demographics and other settings in the subtabs of this screen. Accessing Administrator Central Administrator Central can be accessed … Read More >>
Many TPAs partner with brokers or agencies to sell the TPA’s services. This tab allows TPA users to add and maintain the agencies with whom they have a relationship. The user can also associate specific employers to an agency. * Required fields appear in Red Accessing the Agencies Tab Add Agency / New Agency To add … Read More >>
With Summit, DataPath is able to link different TPA entities in the system under one umbrella TPA. This ability allows a TPA to acquire or administer distinct books of business and manage them all from a single login. The Associated Entities tab of Administrator Central displays the hierarchy of Master and Associated TPAs. NOTE: This … Read More >>
TPA banking details are recorded on the Bank Accounts tab of Administrator Central. These details are used for cash management purposes to track and facilitate the movement of money between Summit and TPAs’ operating accounts. * Required fields appear in Red To Access the Bank Accounts tab: TPA users can view all the associated Bank Accounts … Read More >>
TPA Demographics are configured on the Administrator Central page and the Demographics subtab. * Required fields appear in Red To access the screens containing TPA demographics information: The Primary TPA Demographics fields will display at the top of the page regardless of which subtab is selected. The user may show or hide this section using the “Show/Hide” … Read More >>
At times, DataPath may need to leave TPA specific notes for clients in Summit, which may include both text and attachments. The Notes tab in Administrator Central allows TPA users to view these notes and included attachments. * Required fields appear in Red To access the Notes tab: Notes for the TPA will display on this … Read More >>
The Technical Settings tab in Administrator Central allows TPAs to view and configure certain technical settings within Summit, including: Accessing Technical Settings System URLs Each TPA has its own unique URLs for its Summit portals. Summit URL – This is the unique URL for the TPA’s Summit Admin site. Administrator users will login to Summit … Read More >>
The Participant Portal Settings page allows you to configure and customize the Participant Portal experience for your clients’ participants. Participant Portal Settings may be made at the TPA default level or for specific employers. The Participant Portal Settings page displays (Fig. 2). The TPA’s default settings display and may be configured when the Employer drop-down … Read More >>
The Benefit Resources Center Settings page is located on the Participant Portal Settings page. The goal of this feature is to improve the participant enrollment experience and the general educational content available to participants via the Participant Portal. The Benefit Resources Center Settings page contains DataPath-produced videos to help participants during Online Enrollment. 4. Click … Read More >>
The Participant Portal Settings | General Settings tab allows the user to create a customized Participant User experience on the Summit Participant Portal. To access Participant Portal Settings, NOTE: TPA default settings display may be configured when the Employer dropdown is set to “–Select Employer–“. These settings will be used by any employers who have … Read More >>
Summit allows TPAs to configure providers and provider networks for reporting and reimbursement purposes for CDH plans. In the case of HRA plans, for instance, Employers and TPAs often limit the reimbursement of expenses to services provided by “In-network” providers or they may reimburse the expense at a reduced rate for a service performed “out-of-network”. … Read More >>
Service Codes correspond to different types of treatments or services a Participant may receive from a provider. These codes are utilized during claims processing to determine reimbursement eligibility and copays based on plan designs and the service code attributes. When Service Codes are entered for a claim, it identifies the type of treatment that was … Read More >>
* Required fields appear in Red Many plans, particularly HRAs, have different levels of coverage and other limits. One of the mechanisms of designing such plans and benefits is the use of funding tiers. Funding Tiers may be custom built by administrators based upon specific plan designs. These tiers may be created at the TPA level … Read More >>
DataPath offers our Summit TPA users Business Process Outsourcing (BPO) services to increase administrative efficiency, bring on new groups, and grow your overall business. The Claims Entry BPO service enables DataPath partner Overbrook Technologies to engage in claims entry within Summit on your behalf. Once authorized, Overbrook will perform a number of claim-related business services, … Read More >>
The communications tab contains the settings for the default email, communication notices list, and security email block history. Here the user is allowed to modify the content and format of these communications. A user can view and configure both TPA level and Employer level Communications settings. To access User Communications, On this page, users are … Read More >>
* Required fields appear in Red Summit has been designed to provide TPA the ability to create, delete and maintain user roles with fully customizable feature access associated with each role. Users may be given Read Only or Read/Write access to any combination of features within Summit. TPAs may configure as many roles as they wish, … Read More >>
The user will be presented with default card related settings for that TPA in the Default Card Settings section. The user can view or edit the debit card settings here. There are three sections associated with Debit Card Settings. They are Card Issuance Default, Receipt Management, and Default MCCs. To access Default Card settings, The … Read More >>
The Card Issuance Defaults page is where TPAs configure the default card issuance settings that will apply to all of their Employers that are set up in Summit. Note that TPAs must contact their account rep before a card package may be added in Summit. DataPath will work with you to add a card package … Read More >>
To ensure benefit-linked cards properly adhere to regulatory guidelines, the IRS mandates that cards be restricted to specific MCC Codes (Merchant Category Code), the codes Master Card assigns to merchants to identify the type of merchant they are in an authorization message. On this Default Card Settings page, the user will be allowed to configure … Read More >>
To ensure benefit-linked cards properly adhere to regulatory guidelines, the IRS mandates all cards to be restricted to specific MCC Codes (Merchant Category Code), the codes Master Card assigns to merchants to identify the type of merchant they are in an authorization message. The IRS also requires the review of every transaction to determine its … Read More >>
To ensure benefit-linked cards properly adhere to regulatory guidelines, the IRS mandates that cards be restricted to specific MCC Codes (Merchant Category Code), the codes Master Card assigns to merchants to identify the type of merchant they are in an authorization message. In this tab, the user can view, add, edit, or delete MCC Categories. … Read More >>
In order to ensure cards are used for their intended purposes, the IRS mandates that cards be restricted to specific MCC Codes (Merchant Category Code), the codes Master Card assigns to merchants to identify the type of merchant they are in an authorization message. In this tab, users are able to associate or customize MCC … Read More >>
Receipts are documents used to verify the eligibility of expenses in a transaction. When a transaction cannot be auto-substantiated, the system will automatically generate letters/emails to Participants requesting them to submit receipts or other documentation for expenses that cannot be auto-substantiated. Once this notice is sent, the Receipt Management process will be turned off for … Read More >>
Receipts are documents used to verify the eligibility of expenses in a transaction. When a transaction cannot be auto-substantiated, the system will automatically generate letters/emails to Participants requesting them to send receipts or other documentation for verifying the eligibility of the transaction. Once this notice is sent, the Receipt Management process will be turned off … Read More >>
Receipts are documents used to verify the eligibility of expenses in a transaction. When a transaction cannot be auto-substantiated, the system will automatically generate letters/ emails based on these Receipt Management templates to Participants asking them to send receipts or other documentation verifying the eligibility of the transaction. Once this notice is sent, the Receipt … Read More >>
The Document Manager page allows TPA users to upload documents, organize those documents into categories, and assign them to Employers and Participants. * Required fields appear in Red To access Document Manager, The Document Manager page will display on the screen as shown below. Document Manager Audience Type – When a TPA user accesses the page, … Read More >>
MSP Reporting is automated based on the Submission Period selected by the TPA on the TPA Demographics tab. The file is being generated and uploaded to CMS via SFTP on or before the last day of the Submission Period. Summit retrieves the response file and import the contents. MSP Reporting RRE ID and MSP Reporting … Read More >>
Summit sends email/letter communications to Participants once they are established in the system. On the Participant Communications page, the user will configure the communication settings for Welcome Notices and Card Issuance Communications. The purpose of the Welcome Notice is to inform participants that they have been added to the system and enrolled in benefits/plans and … Read More >>
Plan Default Settings allow for the creation of plan templates, reimbursement schedules, contribution schedules, and benefit orders at a global level. These settings may also be applied at the employer level in ways that deviate from the TPA default settings. To access Plan Default Settings: There are five screens to the Plan Default Settings module. … Read More >>
Participants enrolled in benefit plans may have access to multiple purses with their plan dollars. Different benefit plans cover and pay out different amounts for different products/service based on the plan design. Because Summit allows for many different kinds of plans to be designed and assigned to participants and for those purse values to be … Read More >>
Schedules are pre-defined processes that are used to generate or post Contributions in batches. Contribution Schedules are used to pull contributions for contribution-funded benefits. Summit will automatically calculate contributions from both employers and participants to plans based on Contribution Schedules. The TPA user can add, edit, and view schedules from the Contribution Schedule option in … Read More >>
The Plan Templates screen allows you to set up global benefit templates. Templates for FSAs, Dependent Card, HRAs, Parking and Transit, HSAs, etc. can be configured here at a TPA level and later assigned to employers. * Required fields appear in Red To access Plan Default Settings | Plan Templates, Plan Templates The Plan Templates section … Read More >>
* Required fields appear in Red TPAs may add or modify Plan Templates from the Plan Default Settings | PlanTemplates page. This page includes a breakdown of which settings and defaults will display for the various plan types as well as the definitions for the various settings available on the Plan Templates modal. Plan Template – … Read More >>
* Required fields appear in Red TPAs may add or modify Default Plan Years from the Plan Settings | Plan Templates Page. This page includes definitions for the various settings available on the Default Plan Years modal. By Clicking on the “Add New” button, a page will display as shown below with the following fields. This … Read More >>
* Required fields appear in Red The Denial Codes/Comments section of Plan Default Settings allows you to view and modify the Denial and Request codes for claims submitted for reimbursement through Summit. [Not to be confused with Premium Billing Denial Codes which are used for when an individual is denied coverage.] When reviewing participants’ claims, if … Read More >>
The Plan Default Settings | Reimbursement Settings page is where you will customize the TPA-level business logic by which Summit will process claims and generate reimbursements for participants. To access Plan Default Settings | Reimbursement Settings: General Settings This tab contains run-out/timeout logic settings as well as an option for whether Summit should include the … Read More >>
Summit moves money from designated accounts to create and issue checks as well as ACH payments for participant and provider reimbursement. The banking information necessary to facilitate this money movement for reimbursement may be configured on the Banking/Checking tab of Plan Default Settings | Reimbursement Settings. * Required fields appear in Red To access Plan Default … Read More >>
Summit’s Claims Entry Preferences option allows the user to add fields from a list of Summit-defined optional fields to the claim form, rearrange the position of distinct claim entry fields to better suit the needs of particular groups or plans. To access Claims Entry Preferences, Go to Settings. Click Plan Default Settings. Select Reimbursement Settings. … Read More >>