Summit User’s Guide by Category (based on the menu structure within Summit)
Summit’s Administrator Settings is a top-level Settings category that covers many of the things which Third-Party Administrators (TPAs) must configure to administer benefits within Summit. Administrator Settings and its various sub-pages may be accessed through the Settings menu at the top right. Summit’s Administrator Settings include the following sub-pages: Roles The Roles page is used … 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 >>
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 >>
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 Annual Rates & Limits page displays various regulatory rates and limits in a centralized location for informational and reference usage. The page includes informational tables of IRS-published annual limits and PCOR fee rates, with breakdowns by-year. This information is published by DataPath and updated in accordance with IRS guidelines. The information displayed on this … Read More >>
A TPA’s revenue comes from being able to charge their employer clients a series of fees for administering their group benefits. They typically charge their clients a flat fee for every active participant in the system plus some additional ancillary fees. Summit’s invoicing module allows for TPAs to configure these fees within Summit, using the … Read More >>
TPAs use this system to manage the benefit plans of their employer clients, a service for which they charge those employers. A TPA will typically charge clients a life-count fee per active participant in the system, plus additional ancillary fees. * Required fields appear in Red To access Employer Invoicing CDH, CDH In this tab, the … Read More >>
Premium Billing Employer Invoicing provides monthly invoice reports specifically for PB employers. * Required fields appear in Red To access Employer Invoicing Premium Billing, Premium Billing In the Premium Billing tab, the system will allow the user to configure employer level invoicing for Premium Billing. NOTE: If this was configured at the TPA level, then these … 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 >>
* 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 >>
Advanced Plan Designs allows you to configure a number of settings that have bearing on Administrator-level plan design defaults at a global level without necessarily having to put these settings in place while creating the plans themselves. The Advanced Plan Designs module of Summit includes set up sections for the following (for more in-depth information, … 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 >>
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 >>
Summit allows TPAs to add providers and create provider networks that may be linked to particular benefit plans. These providers and provider networks are configured on the Advanced Plan Design | Provider Networks page. NOTE: For information on third party payees, see the Alternate Payees sections Add a Payee To Add a Payee: NOTE: The … 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 >>
While a single Third Party Payor (TPP) receipt can be applied to a participant’s billing, Summit is also able to apply a TPP receipt to multiple participants via Bulk Receipt Processing. Bulk receipt entry is available for the Third Party Payor functionality on the Employer Central Premium Billing Tab. This allows the user to add … Read More >>
The Communications subsection of Settings is a centralized hub for communications generated by Summit. In addition to being able to configure general communications settings, from this page users can view the Report Repository to which reports designated to do so will be stored for future retrieval, and they may view, upload, and configure user-uploaded files … 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 >>
The Entity Comm page allows users to indicate whether or not to send Report Repository file completion notices to individuals of selected entities. This page includes a radio button toggle that controls whether the communications rules being applied are TPA-level or for a specific Employer. If Employer is selected, a single-select employer dropdown will appear, … Read More >>
The Communications | General Settings acts as a centralized location in Summit for users to configure the general settings for email communications. These settings may be configured generally for all employers linked to the TPA defaults or for a single employer by selecting that employer from the Employer selector. This page contains a grid with … Read More >>
The My Comm subpage of Communications allows users to indicate whether or not they want to receive Report Repository File Completion notifications. This page includes a grid with the following columns:
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 >>
The Report Repository sub-page of the Communications module allows users to search for and view TPA’s Summit-generated report and export files that have been designated to be sent to the Report Repository. Users are able to filter query results by whether the file is TPA(multi-employer) or for a single Employer, by Date Range, Report/Export Name, … Read More >>
The Communications Templates page allows users to view and configure the subject line and content of Report Repository File Completion notifications. The following merge fields are available for inclusion in the body of the communication: Users are able to choose between TPA notifications and Employer notifications on the Templates page. If the user selects Employer … 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 >>
Employer Card Block provides an option to block all cards for an employer so that the user can easily prevent access to cards for all participants of an employer as necessary. Access to the Employer Card Block screen is tied to the “Employer Card Block” role permission under Receipt Management access. Users with Read/Update access … Read More >>
Default Card Settings | Receipt Management | Settings Default Card Settings | Receipt Management | Request Default Card Settings | Receipt Management | Processing
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 following is a list of the various Email Notifications in Summit that can be configured by users and where the system one can find them. TPA Administrator Settings | Online Enrollment | Online Enrollment Administrator Settings | Online Enrollment | Election Changes Plan Default Settings | Reimbursement Settings | Communications Default Card Settings | … Read More >>
Summit is primarily a tool for administering group benefits. As such, it offers extensive employer management capabilities to administrators. The Employer page serves as an umbrella for accessing the demographics and settings particular to your employer clients as well as allowing you to manually add and configure new employer groups. The Employer page and its … Read More >>
Bank Accounts details are necessary at the Employer level for the system to function properly on claim reimbursement, settlement of debit card transactions, etc. A user can create, edit, and view Employer-level Bank Accounts. If needed, users can also terminate accounts from the Employer Bank Accounts tab. * Required fields appear in Red To access Employer … Read More >>
Benefit Orders are arrangements created by the TPA to arrange the Employer Plans associated with specific Service Categories and Codes created by the TPA and to enhance the claim entry process for auto-selecting the appropriate Plan during claim entry. Benefit Order determines the priority logic by which plans will attempt to reimburse participants for the … Read More >>