Reimbursement Settings

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 >>

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 >>