Reimbursement is an act of paying money to Participants for the out-of-pocket expenses they had spent over an eligible service or product. The purpose of the Reimbursement Settings Communications tab is to configure default values at the TPA level that will drive the reimbursement communication process. The Communications tab contains the settings for how Summit … Read More >>
There are several ways in which claims may be entered in Summit—manually by TPA, by participant entry through Participant Portal or the Mobile App, via claim import, by debit card swipe, etc. In some cases, a claim may be submitted multiple times by multiple means. Summit offers Duplicate Claims detection logic to find and weed … Read More >>
* Required fields appear in Red When accessing Plan Default Settings | Reimbursement Settings, the General Settings Tab will display by default. This tab contains settings for how Summit’s logic will handle run-out/timeout for claims, as well as whether the system generated claim numbers will appear on participant letters and display on the Participant Portal. Handling … Read More >>
Reimbursement creation in Summit is a batch process that, like many other processes in Summit, is driven by Schedules. Reimbursement schedules in Summit can be set up and configured at the TPA level from the Schedules tab within Plan Default Settings | Reimbursement Settings. * Required fields appear in Red To access Plan Default Settings | … Read More >>
Summit Premium Billing was developed to allow participants to elect coverage for all benefit plan types. Summit can bill participants, perform remittances, and generate events and notifications for elected coverages using the COBRA, Retiree, and Direct Bill interfaces. Users can edit Premium Billing settings from the Settings menu. To access Premium Billing settings: Premium Billing … Read More >>
The Denial Codes & Comments section of Premium Billing allows users to add, view, and edit denial codes used when an individual is denied coverage. * Required fields appear in Red To access Denial Codes & Comments: Denial Codes In this section, users can add, edit, and delete denial codes. The Codes table (Fig. 3) lists … Read More >>
Summit allows users to customize and create notifications (letters and emails) to meet both TPA and Employer communication needs. This section covers Summit’s Premium Billing communication features, which support sending letters and email notifications between the TPA, Employers, Carriers, and Participants. To access Premium Billing Notifications & Communications: The Notifications & Communications page will display … Read More >>
Summit allows users to configure premium billing plan default settings on this page. Users can set rate expiration alerts and view, modify, and create Employer Templates from this screen. To access Premium Billing Default Settings: Premium Billing Default Settings The Premium Billing Default Settings page is divided into two subsections. They are Rate Expiration Alert … Read More >>
Summit allows a user to enter bank account information at the TPA and employer levels. The account identifies the bank account payments that have been remitted from a TPA’s bank account to a coverage payee. Summit is able to notify the TPA that a remittance schedule has been run and is ready to download. To … Read More >>
The Banking/Checking tab allows the user to select an existing remittance bank account or add and select a new remittance bank account. * Required fields appear in Red To access Remittance Settings | Banking/Checking, Banking/Checking The Banking/Checking tab is selected by default and contains three sections: General Operating Account The General Operating Account section of the … Read More >>
Schedules are arrangements that define when certain processes must be carried out, including a list of events and times. Users can add, edit, and view created Remittance Schedules in the Schedule tab of the Premium Billing | Remittance Settings page. * Required fields appear in Red To access Premium Billing Remittance Schedules, The Premium Billing Remittance … Read More >>
Screen Customization allows users to modify the appearance of the administrative views of Summit, the Participant Portal, and the Summit Mobile App. Users can upload images and customize the color of screen elements. To access Screen Customization Settings, Screen Customization Settings The following sub-menus are available for Screen Customization: Click the hyperlinked Screen Customization settings for … Read More >>
For Summit employer users, an employer dashboard is an alternative landing page to a traditional home page. On this page, a user can customize the employer dashboard screen by configuring its widget background color and adding/removing individual widgets. The system will automatically adjust the placement of widgets when they are added or removed. If the … Read More >>
The Mobile Screen Customization page allows the TPA user to customize the look of the Summit mobile application. TPAs can upload logos and customize the colors of certain texts and areas of the screen. To access the Mobile Screen Customization page: Mobile Screen Customization By clicking on the Mobile option, the following customization page will display: Assign to Administrator … Read More >>
The Screen Customization | Participant Portal page allows TPAs to create unique designs for their participants’ Summit Portal. From this screen, a user will have the option to upload images and customize the color of various screen elements. To access Participant Portal Screen Customization, Participant Portal Screen Customization By selecting the Participant Portal menu, the screen customization page will … Read More >>
The Summit Screen Customization page allows users to create a flexible user interface by customizing the look of the system. Users can upload images and customize the colors of certain texts and areas of the screen. To access Summit Screen Customization, Summit Screen Customization By clicking the Summit menu, the screen customization page will display as follows. Here, the … Read More >>
Summit allows participants to enroll in benefit plans online via the Participant Portal. The online enrollment process is determined by the settings configured on the Administrator Settings Online Enrollment page. TPAs may configure their Online Enrollment settings globally or assign specific settings to individual employers that are not assigned to the TPA default. The purpose … Read More >>
* Required fields appear in Red As a multi-layered platform offering a wide range of services and views for multiple stakeholders and entities, Summit can accommodate many different users with different roles and levels of access. The Users modal allows TPAs to create and modify Summit user accounts and assign roles to those users, including TPA … Read More >>
Summit allows for a significant degree of Carrier integration, including the ability to use Carrier Claims Matching, whereby Summit can use data from a Carrier Claim Feed as an additional auto-substantiation method. The Carriers tab in Administrator Central allows TPAs to add carrier data into Summit and associate specific employers with those carriers for auto-substantiation … Read More >>