The Centralized Performance System (CPS) Indemnity Module Insurer View CPS Logon Page Forgot Your Password? Use the link at the bottom of the screen Click.
Download ReportTranscript The Centralized Performance System (CPS) Indemnity Module Insurer View CPS Logon Page Forgot Your Password? Use the link at the bottom of the screen Click.
The Centralized Performance System (CPS) Indemnity Module Insurer View CPS Logon Page Forgot Your Password? Use the link at the bottom of the screen Click here CPS Organizational Chart CPS Overview Performance information is detailed and summarized in CPS on a monthly basis. A batch is the sum of all of an insurers DWC-1s submitted and processed by the Division in a calendar month. Summary Batch Overview Summary Penalty Overview Summary Penalty Detail Detail Page View Click on the SSN hyperlink to access the individual DWC-1 claim’s data pop-up screen for that claim. DWC-1 Pop-up This screen contains data from the DWC-1 and specific claim and penalty information. Toggling Between TPAs Use the drop down box at top right of the screen. View All Screen This screen allows viewing of all DWC-1s submitted in a batch. You can download this information into either an excel or CSV format. MS Excel Output… CSV Output… Sending a Batch to the Workbench… The Workbench “To Do” List… The “To Do” list shows batch penalties for insurer and employer. An insurer will only have access to their penalties. The Penalty Detail Overview… Notes Overview View Notes from the Workbench or Summary Pages Add Notes only from the Workbench Notes may include attachments All notes are PERMANENT! Two Different Levels of Notes… CPS Indemnity Note Types: Batch Notes: Apply to the batch as a whole. They can be added at any time and viewed by all. Detail (Penalty) Notes: Apply to a specific penalty, filing or payment. They can be viewed by the Division only after the batch has been submitted. Again: All notes may include attachments. All notes are PERMANENT! Allowed Attachments Include: 1. htm 2. html 3. pdf 4. txt 5. doc 6. xls 7. tif 8. tiff 9. rtf Viewing Batch Level Notes Batch Documents Notes can be viewed from the Summary tab or the Workbench tab. This is how Batch Document Notes look in the System… Notes Notes can only be added under the workbench tab. Adding Penalty Notes Each time a filing penalty is disputed a note must be added to explain the reason for the dispute. ALL payment penalty statuses (Concur or Dispute) must be accompanied by a note. Batches cannot be submitted to the Division until each penalty that is disputed has a note. Enter Penalty Detail Notes for Timely Filing and Timely Payment Enter Notes in the Timely Filing Penalty Document Notes Area Type in note text. Click “Browse” to add and attachment then click save. Enter Notes in the Timely Payment Penalty Document Notes Area Saved attachment Chose a Note Type. Type in note text. Click “Browse” to add an attachment then click save. Insurer Statuses – Timely Filing and Timely Payment Penalties Dispute: The Insurer Specialist has reviewed a penalty’s DWC-1 claim information and does not agree that a penalty should have been assessed. Concur: The Insurer Specialist has reviewed a penalty’s DWC-1 claim information and agrees that the penalty is valid. Assigning Timely Filing Penalty Statuses Assigning Timely Payment Penalty Statuses Addressing Multiple Timely Filing Claims with “Concur” Insurer Status A close up of filing penalty statuses… Addressing Individual Timely Filing Claims Click on the “New” hyperlink under the “Insurer Status” to access a specific claim Addressing a Specific Timely Filing Claim (1) Select “Insurer Status” (2) Select a note type (3) Type in Note text. (4)Click Browse to add attachment (5) Remember to click “Save” Timely Payment Penalties… Timely Payment penalties can only be evaluated one at a time. All Timely Payment penalties are evaluated from the Timely Payment Work Area, which is accessible via the Workbench Penalty Details Page. Addressing Individual Timely Payment Claims Click on the “New” hyperlink under the “Insurer Status” to access a specific claim Insurer Statuses – Timely Payment Penalties Dispute: The Insurer has reviewed a DWC-1 claim penalty and does not agree that a penalty should have been assessed. Concur: The Insurer has reviewed a DWC-1 claim and agrees that the penalty is valid, and must submit proof of payment to the Division through CPS. Addressing a Specific Timely Payment Claim (1) Select “Insurer Status” (2) Type in Note text. (3)Click Browse to add attachment (4) Remember to click “Save” Batch Submission Before submitting a batch all penalties must have an Insurer Status of Concur or Dispute. A note must be added to each filing penalty with an Insurer Status of Dispute. A note must be added to ALL payment penalties as well as proof of payment or documentation to support a dispute. Performing a Final Check… The CPS “To Do” List displays the number of penalties (filing and payment) that still need to be addressed before submission. Completed Not completed How to perform a final check… All penalties that have not been addressed will have a status of New. The system WILL NOT indicate which penalties do not have notes on them. (HINT: Add Notes when the penalty status is assigned to avoid confusion later.) Submission of a Completed Batch Click on the batch to be submitted. Check to see that both Timely Filing and timely Payment Penalties are “Complete”. Click on “Submit”. “Y” means both penalties (filing and payment) are ready for submission. Remove this item from my workbench… Use this feature if after processing a batch you wish to cancel all changes made during the processing of the batch and send it back to the place from which it came (literally!). This is the only method by which Notes can be deleted but does so at the cost of eliminating all work performed in the batch as well. The Confirmation Page… Submit After clicking the “Batch Selection” button, clicking the “Submit” button will initiate the system’s review of the batch. If any penalties have not been addressed or if any disputed filing penalties do not have a Note the system will prompt the user. Batches that pass the Final Check are submitted to the Division for evaluation. If the batch is not complete… And after you have clicked the “submit” button… “N” indicates batch needs to be addressed before submission. You will receive the following error message If submission is successful: The batch is no longer on the Insurer’s workbench. The batch is viewable on the Insurer’s summary pages. The batch has been moved to the workbench of a Specialist at the Division of Workers’ Compensation. Specialists are dedicated to working the batches of specific Insurers. And then? The Specialist assigned to the submitted batch will process within 15 business days. The Specialist will review all disputed penalties and the notes/attachments associated with them. The Specialist will determine if any of the disputes are acceptable according to current law, Administrative Rules and the policies of the Division of Workers’ Compensation. Finally… The Specialist will recalculate the batch if any disputed penalties were accepted. The batch will be returned to the Insurer’s workbench reflecting the new penalty amount. The Insurer can choose to pay in full or pay in part. Special note: If an insurer has Timely Filing penalties in excess of $10,000, the penalty will be recalculated so that each untimely filing occurence above $10,000 will be assessed a penalty of $25. For now: Let us assume that the batch will be returned and the Insurer has decided to pay for the batch in full or in part. All other scenarios will be addressed in the following slides. Viewing Batch Payment Information Once a batch has been submitted it is no longer accessible on the Insurer Workbench. Payment Information can be accessed from the Summary tab or from the Payments tab. Note: Partial payments will not be reflected on the Summary tab. Be sure to review the payment tab before issuing payment. Batch Payment Information Do not make payments using this screen since this page does not reflect partial payments and could result in overpayment. The Payment Screen and Options For Traditional Check Payments Batch Payment Notes When viewing the information on the Payment Screens please consider the following: 1. The batch payment amount is current as of the last saved batch action. 2. The batch payment amount might change once reviewed by the Specialist assigned to the Insurer’s account as a result of recalculation. 3. It is possible to make a payment on a batch at any time. 4. In general, a batch penalty amount can decrease according to the number of disputed penalties that are accepted by the Specialist assigned to the account. 5. Data corrections can change penalty amounts that are due. Penalty Recalculation Notes… If a Notice of Violation (NOV) has been sent and the batch has been processed by the Insurer Specialist and Division Specialist it is possible (but not necessary) to request a new Notice of Violation. Payment for the batch can be made without a new NOV. Batch Payment Options: Payment can be made manually with a check There are two payment options available at any time. – A Full Payment is simply the total batch payment amount. – A Partial Payment is the sum of all concurred filing penalties in a batch. Partial Payment A partial payment can be made if the Insurer receives the initial review of the batch penalties and feels that some or all of the disputed penalties that were denied by the Specialist should be reviewed again by the Division of Workers’ Compensation. The CPS automatically calculates the partial payment amount as the sum of all concurred penalties in the batch. Disputed penalties that were accepted by the Division are nullified and do not have an effect on the batch penalty amount. Full Payment A Full Payment shall be made when the Insurer agrees that all batch penalties have been sufficiently evaluated and no further action is necessary. Once the full payment amount is received by the Division the batch balance shall be adjusted to zero and the batch will close. A closed batch is only viewable on the Summary Pages and cannot be reopened. How do I make a Partial or Full Payment? Enter Check Information Payment Saved… Note: The insurer should print the “Payment Statement” to send with the payment to the Division. Payment Listed… The Centralized Performance System Indemnity Module Administrative Functions Administrative Actions The Insurer Administrator can: Create New Sub-Accounts. Edit the Permissions of Existing Sub-Accounts. Lockout/Unlock Sub-Accounts. Control TPA Access to Insurer batches. Creating New Sub-Accounts Insurer Administrators have the authority to create sub-accounts for their company and grant them permissions. There is no limit to the number of sub-accounts that can be created. To create a sub-account… Click the “Add New” link… What happens next? Once the Add New link is clicked the Account Administration Detail Page is displayed. This page is essentially a blank user template. Some information about a new user must be entered to create the account. Sub-account fields to define include: • Contact person: This is the name of the sub-account user. • E-mail Address: This is the email address the sub-account user wishes to receive CPS messages at if they are given privileges to do so by their Administrator. Account Creation Part I… Editing Existing Sub-account permissions The permissions of existing sub-accounts may be modified by the Insurer Administrator as needed at any time. For details on how to edit existing user permissions please observe the following stepby-step example. Account Access Rights - one of three levels: View Items and Add Notes: View Items and Update Status: This level of permission is intended for use by managers, auditors, or any other agents the company wishes to empower to view ALL of the firm’s CPS data as well as add notes to CPS batches. This level of permission is intended to be used by personnel who will actively process CPS batches before they are submitted to the Division of Workers’ Compensation. Users with this level of permission can do everything listed above but can also assign penalties a status of Concur or Dispute. Submit Batches: Users with this level of permission can view and add notes to batches, assign penalty statuses, and submit batches to the Division of Workers’ Compensation. By default this permission is given to each company’s Insurer Administrator. The Insurer Administrator can decide whether to retain this privilege or grant it to any number of subaccount users. Account Creation Part II… The password will be sent via email to the addressee you will need to grant a level of access for this account. Once you have done this click save. To edit an existing sub-account… Click the “Edit” Link… The User’s Account Opens… The selected user’s profile opens. Please make note of the usage of the buttons at the bottom of the screen as well. They are: Buttons on the User Accounts Page are: • Save Record: Clicking this button will commit any changes made to a user’s record. • Cancel: This button will cancel any changes made to a user’s record since accessing their profile. • Delete: Clicking this button will delete the user’s account. Optional Features… Optional features of the User Accounts Page are discussed here. These features include: – – Lockout: Clicking inside the Lockout check box will lock or unlock a user’s account. Lockout can occur by the Insurer Administrator or by the Division of Workers’ Compensation. The lockout checkbox provides functionality to use this feature of the system. Receive Pre-NOV Email: If this checkbox is checked the user will receive any Pre-Notice of Violation e-mails sent by the system. The Administration Subaccount Detail Page… A snapshot of the Receive Pre-N.O.V., Lockout and Security controls: The Cc E-mail Control… The CC: text box is only listed on the Profile Page of the Insurer Administrator. In the event that multiple parties wish to receive automated messages from the CPS their e-mail addresses can be added to the Cc Email text box. Once their email address is input in the Cc Email box and the Save button is clicked all subsequent system messages of the CPS will be sent to these persons. A Close-Up of the Cc E-mail Control… TPA Assignment Note: A TPA will show up on the TPA Assignment tab once CPS begins reviewing their claims. (1) Click on Select (2) Choose Access (3)Remember to click “Save” TPA Address Pop-Up… The Reports Tab… Click on report links to generate a report Select a date range… VOILA!!! Contact Outside of the System… 1. Refunds. 2. Preservation of Rights / Requesting a Hearing by DOAH or the JCC. What About Refunds? The system automatically flags any batch which balance becomes negative with a status of “Refund Due.” Refunds cannot be processed until 30 days after the date the Division received the final payment on that batch. Specialists shall issue requests for any of their client’s batches with the “Refund Due” status. All refunds are required to have an “Application for Refund” completed by the entity that issued the last payment. Preservation of Rights / Requesting a hearing by DOAH: The final administrative privilege discussed is used only if a resolution to batch penalties cannot be found by working within the system. In the event an Insurer wishes to preserve their rights and/or request a hearing by the Department of Administrative Hearings a written request must be filed with the Division within 21 days of receiving the Notice of Violation. The Notice of Rights and Notice of Violation are sent to Insurers (only if batch penalties have not been resolved through the CPS during the Preliminary Notice of Violation Stage) by Certified Mail. The 21-day clock begins when the Division receives the Certified Mail Receipt. Questions? Should you have further questions or concerns contact your Specialist. The name of your assigned specialist can be found at the bottom of your profile tab. You can call 1-850-413-1608 and request that person. If they are not available you can request to speak with the Indemnity Administrator.