The Centralized Performance System Indemnity Module

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CPS Basics
The Centralized Performance System Indemnity
Module
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CPS Logon Page
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Forgot Your Password? Use the link at the bottom
of the screen
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Web Page Hierarchy
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TPA Web Page Hierarchy
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Centralized Performance System 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.

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Summary Batch Overview
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Summary Penalty Overview
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Summary Penalty Detail
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Detail Page Zoom
Clicking on the SSN link on the far left accesses
the DWC-1 pop-up screen.
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DWC-1 Pop-up contains data from the DWC-1 and
specific penalty detail information.
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Toggling Between TPAs Use drop down box at top
left of the screen
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The View All Screen allows viewing of all DWC-1s
submitted in a batch
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MS Excel Output
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CSV Output
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Sending a Batch to the Workbench
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To Work or Not to Work?
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Selecting a Batch
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The Workbench To Do List
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Notes Overview

• View Notes from the Workbench or Summary Pages
• Add Notes only from the Workbench
• Notes may include attachments
• All notes are PERMANENT!

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Two Different Levels of Notes

• CPS Indemnity Note Types
• Batch Notes Apply to the batch as a whole.
• Detail (Penalty) Notes Apply to a specific
  penalty, filing or payment.

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Allowed Attachments Include

• htm
• html
• pdf
• txt
• doc
• xls
• tif
• tiff
• rtf

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Viewing Batch Level Notes
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This is how Batch Notes lookin the System
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Notes must be addedfrom the Workbench
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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 requires a note has one.

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Click the Notes hypertext link
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Add Note text and click Add Notes.
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Assigning Filing Penalty Statuses

• Insurer Statuses - Timely Filing Penalties
• Dispute The Insurer Specialist has reviewed a
  penaltys DWC-1 claim information and does not
  agree that a penalty should have been assessed.
• Concur The Insurer Specialist has reviewed a
  penaltys DWC-1 claim information and agrees that
  the penalty is valid.

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Penalty Detail Method
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A close up of filing penalty statuses
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Timely Filing Work Area
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Timely Payment Penalties

• Timely Payment penalties must be evaluated one at
  a time.
• All Timely Payment penalties must be evaluated
  from the Timely Payment Work Area, which is
  accessible via the Workbench Penalty Details Page.

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Timely Payment Work Area access
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Timely Payment Work Area
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Timely Payment Penalty Statuses

• Insurer Statuses - Timely Payment Penalties
• Dispute The Insurer Specialist has reviewed a
  penaltys DWC-1 claim information and does not
  agree that a penalty should have been assessed.
• Concur The Insurer Specialist has reviewed a
  penaltys DWC-1 claim information, agrees that
  the penalty is valid, and shall submit proof of
  payment to the Division electronically via the
  system or by postal mail.
• HINT Submitting proof of payment via the CPS is
  faster!!!

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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.
• Note attachments are optional.

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Performing a Final Check

• The CPS To Do List displays the number of
  penalties (filing and payment) that are not
  complete.

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How to perform a final check

• All penalties that have not been regarded will
  have a status of New.
• The system WILL NOT automatically indicate which
  penalties do not have notes that require them.
  (HINT Add Notes when the penalty status is
  assigned to avoid confusion later.)
• Use the Insurer Status and Notes column headers
  to quickly sort the data grids and locate the
  incomplete items on the penalty details pages.

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Batch Submission

• How is a batch submitted?
• What options are available when doing so?

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The Workbench Batch Overview Page
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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 (as close as possible), but does so at
  the cost of eliminating all work performed in the
  batch as well.

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Submit

• Clicking the Submit button will initiate the
  systems review of the batch.
• If any penalties have not been regarded 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.

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A close up of the buttons
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The Confirmation Page
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If the batch is not complete
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If submission is successful

• The batch is no longer on the Insurers
  workbench.
• The batch is viewable on the Insurers 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.

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And then?

• The Specialist assigned to the submitted batch
  will process it in a timely manner.
• 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
  and the policies of the Division of Workers
  Compensation.

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Finally

• The Specialist will recalculate the batch if any
  disputed penalties were accepted.
• The batch will be returned to the Insurers
  workbench.
• The Insurer can choose to pay in full or pay in
  part.

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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 next
  session.

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Viewing Batch Payment Information

• Once a batch has been submitted it is no longer
  accessible on the Insurer Workbench.
• The batch is accessible on the Summary pages.
• Payment Information can be accessed there or from
  the Payments tab.

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Batch Payment Information
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The Payment Screen
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Penalty Recalculation

• Once a batch is submitted to the Division of
  Workers Compensation the Specialist assigned to
  the account will review all penalties in the
  batch.
• If one or more disputed penalties are accepted
  the Specialist will re-calculate the batch
  payment amount.
• The new batch penalty amount is available
  immediately after the Specialist returns the
  batch to the Insurer Workbench

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Batch Payment Notes

• When viewing the information on the Payment
  Screens please consider the following
• The batch payment amount is current as of the
  last saved batch action.
• The batch payment amount might change once
  reviewed by the Specialist assigned to the
  Insurers account as a result of recalculation.

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Batch Payment Notes continued

• It is possible to make a payment on a batch at
  any time.
• 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.
• Data corrections can change penalty amounts or
  installment liability.

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Penalty Recalculation Notes

• If a Notice of Violation has been sent and the
  batch has been processed by the Insurer
  Specialist and Specialist it is possible (but not
  necessary) to request a new Notice of Violation.
• Payment for the batch can be made without a new
  N.O.V.

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Batch Payment Options

• 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.
• Lets discuss when to use each method.

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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.

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Full Payment

• A Full Payment can be made whenever the Insurer
  feels that all batch penalties have been
  sufficiently evaluated and reviewed 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.
• At this point the batch is only viewable on the
  Summary Pages.

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How do I make a Partial or Full Payment?
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Payment Entered
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Payment Saved
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Payment Listed
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The Centralized Performance System Indemnity
Module Administrative Functions
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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.

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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.

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To create a sub-account
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Click the Add New link
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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.

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Account Creation Part I
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Account Creation Part II
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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.

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What access rights shall the user have?

• Account Access Rights (one of three levels)
• View Items and Add Notes 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 firms CPS data as
  well as add notes to CPS batches.
• View Items and Update Status 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
  companys Insurer Administrator. The Insurer
  Administrator can decide whether to retain this
  privilege or grant it to any number of
  sub-account users.

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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
  step-by-step example.

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To edit an existing sub-account
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Click the Edit Link
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The Users Account Opens

• The selected users profile opens.
• Please make note of the usage of the buttons at
  the bottom of the screen as well. They are

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The Account Administration Detail Page
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Buttons on the User Accounts Page are

• Save Record Clicking this button will commit any
  changes made to a users record.
• Cancel This button will cancel any changes made
  to a users record since accessing their profile.
• Delete Clicking this button will delete the
  users account.

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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 users 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.

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These User Profile Controls Look Like

• A snapshot of the Lockout, Security and Receive
  Pre-N.O.V. controls

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The Cc E-mail Control

• This checkbox 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.

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A Close-Up of the Cc E-mail Control
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Lockout / Unlocking of Sub-accounts

• The power to lock and unlock sub-accounts can be
  used in two ways.
• Lets discuss both lockout scenarios.

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Lockout by the Division

• The Division of Workers Compensation reserves
  the right to lock any Insurer out of the CPS at
  any time.
• A system e-mail message shall be sent to the
  Insurer Administrator of the affected Insurance
  Company notifying them of the lockout.
• All sub-accounts of the affected Insurer are
  locked out by default.
• If the Insurer Administrator or a sub-account
  user attempts to logon to the CPS a message is
  displayed informing them of the lockout and asks
  them to contact their Specialist at the Division
  of Workers Compensation for further information.
• Once the Division unlocks the Insurance
  Administrator account, it is the duty of the
  Insurer Administrator to unlock each of their
  sub-accounts (performed by a single click of a
  check box) and notify them that their account is
  once again operational.

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Account lockout at the Insurers discretion

• The Insurer Administrator reserves the right to
  lock any of their sub-accounts at any time.
• Locking out a sub-account user is as easy as
  clicking inside a check box on the Administration
  Page of the CPS.

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TPA Assignment
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Close Up
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TPA Address Pop-Up
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The Reports Tab
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Select adate range
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VOILA!!!
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Contact Outside of the System

• Refunds.
• Preservation of Rights / Requesting a Hearing by
  DOAH or the JCC.

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What About Refunds?

• The system shall automatically flag any batch
  whose balance becomes negative with a status of
  Refund Due.
• Specialists shall issue requests for any of their
  clients batches with the Refund Due status.

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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.

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Questions?

• Should you have further questions or concerns
  contact your Specialist at 1-850-413-1608.