Indemnity & Payments
Can checks be issued the same day they are due?
No, all checks must be entered the day before.
What should every activity completion include?
A note documenting the action taken.
Are claims assistants allowed to work unapproved overtime?
No, all overtime must be approved by management.
What is the STRICT cutoff time for same-day mailing through in-house Ops with a POS?
2:00 PM AZ time (1:00 PM PDT).
Who provides all instructions for benefit payments?
The Claim Adjuster.
What is the maximum number of weeks a TTD payment can be entered at one time for auto pay?
8 weeks
What should be included in the file and service note?
Document names, dates, and doctors’ names if applicable.
What topic category should be utilized for all work status calls?
Provider Contact
If POS is not required, should you forward it to CP Certified?
No, should go through batch print.
Who enters the payment according to the “How to Make an Indemnity Payment” process?
The claims assistant.
How often must TPD payments be recalibrated?
Every two weeks.
Who shares responsibility for data integrity?
Both the claim adjuster and the claim assistant.
What is the requirement for work hours and breaks?
Work 8 hours per day with two 10-minute breaks and a lunch away from the desk.
When sending large mailings (over 200 pages), who should handle it?
Hard Copy.
Who issues benefit notices in ECC?
The claims assistant.
Why is it important to issue timely benefit payments?
To avoid penalties and ensure compliance with California State Audits (DWC).
When paying TTD benefits, is a note required with each payment, even when on auto pay?
Yes, a note is required and should document remaining reserve balance.
When should items received from Hard Copy be uploaded to the claim file?
By the next day.
What items must be uploaded together?
Signed Proof of Service, index, and any related correspondence.
When going on PTO, what must a CA complete in advance?
Compensation payments.
What is the maximum number of weeks that can be paid for severe burns, amputations, severe eye injuries, HIV, and certain chronic lung and liver diseases.
240 weeks
What should be done when an adjuster does not address reserve changes within three days?
Escalate to the supervisor.
Should tasks ever be re-diaried or moved without an action being taken and documented?
No, they must be completed with a note entered in the system and a new activity created as applicable.
Where do you send documents with Proof of Service to under 200 pages (exact email address)?
cpcertifiedpos@copperpoint.com.
What is the CA’s primary purpose according to Liselle?
To issue payments and benefit notices accurately and timely per DWC regulations.