Hotline Standards
This is the minimum monthly quality standard.
What is 92% or higher per month?
These two DAVE options can both take a representative to the claim injury section.
What are 70CI Employee Master Claims Inquiry and 20CP Claims Processing?
Faxed, mailed, or emailed attorney claims must be sent to this department before entry.
What is Compliance?
These four states require the injured worker to use the employer's provider panel for initial treatment.
What are Georgia, Pennsylvania, Tennessee, and Virginia?
An ImageRight note for a correction should begin with these words.
What is “Intake Update”?
This is the expected hotline service level.
What is 90% or higher?
Along with the injured worker's name, this date is required to verify or provide claim information when the last four digits of the SSN are unavailable.
What is the date of injury?
This type of attorney claim may still be entered immediately.
What is a phone claim from an attorney?
This state permits employee choice and currently has no provider network available.
What is Texas?
This form name is used to fax Florida treatment authorization to a provider.
What is FLFAXTRAU – Fax Treatment Authorization Form to Provider?
This is the average daily ACD call range for employees with the hotline skill only.
What is 15 to 20 calls per day?
This must be included when entering a claim number that begins with zero.
What is the leading zero?
Attorneys may not be given this policy information, including specific start or cancellation dates.
What are policy coverage dates?
These four states allow physician panels to be requested from the Summit website.
What are Georgia, Tennessee, and Virginia, Pennsylvania?
For a Florida NOI reported more than 30 days after the injury, this person alone directs treatment.
Who is the assigned Florida adjuster?
This is the combined-stat talk-time goal for Month 3 of the Hotline Only Trainee Program.
What is 11 minutes, 30 seconds?
If the date of injury is off by a few days, verify this injury detail before providing information or sending the caller to the adjuster.
What is the body part or type of injury?
An attorney reporting a claim should not receive this after the claim is entered.
What is an email confirmation?
For a dental emergency requiring immediate treatment, complete the claim and then take this action.
What is transfer the injured worker to the adjuster and provide the claim number and necessary injury details?
These are the BIN, processor control, and group numbers used by a pharmacy for an after-hours first fill.
What are BIN 003858, processor control WC, and group G69A?
This phone number should be given to someone attempting to report a claim for a Summit employee.
What is 1-888-800-3584?
These are the four regional adjuster phone numbers listed in the guide: Main, Florida, Southeast, and Southwest.
What are Main 800-282-7648, Florida 800-282-7644, Southeast 800-863-2181, and Southwest 888-468-2539?
These six examples of legal documents are listed for documentation in the Claims note.
What are a Petition for Benefits, Request to Produce, Notice of Appearance, Legal Letter or Letter of Representation, Grievance Letter, and Request for Assistance?
This network may be suggested in Arkansas, but the representative must not say it is required.
What is the Arkansas Blue Cross Network?
During the first prescription fill, this number serves as the injured worker's temporary ID; afterward, the pharmacy uses the generated nine-digit ID.
What is the injured worker's Social Security number?