The Summit has been designed to produce reimbursements to participants for the claims they have submitted to the TPA. TPAs can enter claims submitted by participants and specify a reimbursement method for those claims and create reimbursement checks/ACH files. The On Demand Reimbursements tool on the Participant Central | Transactions tab allows TPA users to … Read More >>
One of the primary functions of Summit is processing claims submitted by participants of CDH plans for reimbursement from their plan purses. Summit allows participants to use debit cards to access their accounts. Through the Debit Card tab of the Transaction Review page, the TPA can view and adjudicate all pending debit card transactions. * Required fields appear in Red … Read More >>
* Required fields appear in Red Summit can generate Check 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 for processing and participant reimbursement. The goal of DataPath File Fulfillment is to enable TPAs to use DataPath’s banking partner for automated processing of Check files—eliminating the need for manual … Read More >>
* Required fields appear in Red When entering manual claims for participants or dependents, the claim is linked to a provider entity from the list of providers available in the Provider dropdown. In cases where the provider for the claim does not exist in Summit, you can create a new provider during the manual claim entry … Read More >>
Receipts are documents used to verify the eligibility of expenses in a transaction. When a transaction cannot be auto-substantiated, Summit will automatically generate letters/emails to Participants requesting them to send receipts or other documentation verifying the eligibility of the transaction. Once this notice is sent, the Receipt Management process will be turned off for that … Read More >>
* Required fields appear in Red During the process of entering a manual claim for a participant, you may find that you need to add a new dependent for the participant who has not yet been entered in the system. You may add dependents to the participant from the Manual Claim entry process by clicking the … Read More >>
Manual Claims may be entered for participants for reimbursement from the Processing | Transaction Entry page by selecting the Manual Claim transaction type. This page outlines the process for entering Manual Claims in Summit. * Required fields appear in Red To enter a Manual Claim, Manual Claim When the user selects Manual Claim as the transaction type, the … Read More >>
Removal of Contribution provides the TPA the ability to correct HSA contribution amount mistakes retroactively. This includes identifying the source of the contribution(s), the date(s) on which the contribution(s) was made, the tax year to which the contribution was applied, and the amount to be returned. The correct information will be sent to HSAToday to facilitate … Read More >>
The Unassigned Images tab allows TPA users to review received image files/documentation and assign them to claim transactions. Options available here include: Only TPA users for whom the Summit Zip-Line™ EDM Feature Access is selected can access the Unassigned Images tab. * Required fields appear in Red To access Unassigned Images, Unassigned Images When users select Transaction Review > Unassigned Images, the following fields will … Read More >>
The Return of Withdrawal is a type of contribution that decreases total distributions but does not affect total contributions. It increases the available balance of the account, and once fully posted, it increases the disbursable balance as well. * Required fields appear in Red To access Return of Withdrawal, Return of Withdrawal When the user selects Return of Withdrawal as … Read More >>
TPAs can manually enter Plan Repayment transactions. A Plan Repayment is applied to specific ineligible/expense denied transaction(s). A Plan Repayment may not apply more money to the plan than what was taken from the plan by the ineligible/expense denied transaction(s). When the Plan Repayment is applied to the transaction, the repayment increases the balances of the plan(s) to which the claim was applied. … Read More >>
Some plans (typically an HSA) allow participants to request a distribution of funds from their plan without the need to justify the expense or submit receipts. This transaction type is known as Withdrawal. It is similar to a manual claim. When a withdrawal is entered, it reduces the balance of the participant and results in a … Read More >>
Manual Contribution allows users to manually enter contributions, either positive (adding money) or negative (removing money), outside of a contribution schedule. * Required fields appear in Red To access Manual Contribution: Manual Contribution If Manual Contribution is selected from the dropdown list, the system will present the user with a manual contribution entry screen. This screen will allow the … Read More >>
Sometimes there will be a need for TPA to put funds into a Participant’s account for reasons not specifically associated with a transaction in an Ineligible or Expense Denied status. In this case, the system will allow the user to select a Claim Type called Credit. * Required fields appear in Red To access Credit, Credit … Read More >>
The Premium Billing tab of Employer Central allows for the setup of premium billing information at the employer level, including the setup of banking information, subsidies, and Third-Party Payors. Here, the employer may be associated with an administrator-level template or assigned settings that may deviate from those templates and how those settings will apply for … Read More >>
Carrier claim files for import and carrier EOBs that TPAs receive and use to enter claims in Summit often contain amount fields that do not correlate to what Summit uses for total Claim Amount, Ineligible Amount, and Approved Amount. To allow for TPAs to account for these discrepancies, users may define formulas for calculating the … 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 >>
In order to help 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. Each employer plan will be accessible via a set of … 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). MCC Codes are the codes that Master Card assigns to merchants. It helps to identify the type of merchant in an authorization message. Summit has default MCC categories as well … 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 Management … Read More >>
To ensure the proper use of cards, the IRS mandates all cards to be restricted to some specific MCC Codes (Merchant Category Code). MCC Codes are the codes by which Master Cards assign to merchants. It helps to identify the type of merchant in an authorization message. The IRS also requires the review of every … Read More >>
While Summit allows TPAs to create administrator-level default settings for how Summit debit cards behave in regards to Merchant Category Codes, Summit users may also configure settings at an employer-level from the Employer MCCs page. For more information about each of these tabs, click the linked heading. Plan MCCs The Plan MCCs tab allows users … Read More >>
* Required fields appear in Red Add New Carrier The Add Carrier link on the Premium Billing tab of the Add Plan modal will open an Add Carrier popup modal that will allow you to configure settings for the carrier to be associated with the premium billing plan. Demographics Administration Contacts If the user wishes to … Read More >>