TREAT’s billing module includes functionality for multiple types of billing requirements.

TREAT also includes functionality to track grant-based funding, and organizations have the ability to create organization-specific procedure codes to track activities related to grants or other types of activities that require internal tracking and reporting. TREAT supports monthly billing reporting requirements, or other case management type billing requirements.

While TREAT’s billing module is native to the application, the system also includes an integrated component that links the Change Healthcare (formerly Emdeon) clearinghouse. On the TREAT side, a number of data validity and edit checks are completed to validate the claims and compile them into submissions. The submission files are sent in 837 format and undergo a second validation process through Change Healthcare’s clearinghouse. Because Change Healthcare is one of the most established clearinghouses in the country, they are able to include the most up to date validations and checks based on their relationships with the various payers. Once the claims have passed these validations, they are sent via electronic submission to the payers. In cases where the payers do not accept claims electronically, Change Healthcare prints and mails claims based on the files submitted. There is no need for the end customer to manage these claims separately.

Electronic Remittance Advice is received back into TREAT automatically, and claims are updated and posted via this process. Any denials will also be received, with all details received from the payer displayed with the claim. In cases where payers do not support electronic reconciliations, payments can be manually posted within TREAT.

In addition to real-time requests, the system can be configured to perform a nightly automatic “batch” request for clients with scheduled appointments, as well as a periodic batch request for enrolled clients (e.g. bi-weekly or monthly).

An alert can be configured to notify selected users (e.g. the client’s case manager, or the client’s care team) if the eligibility query comes back as ineligible. An eligibility report is also available.

In addition to real-time requests, the system can be configured to perform a nightly automatic “batch” request for clients with scheduled appointments, as well as a periodic batch request for enrolled clients (e.g. bi-weekly or monthly).

An alert can be configured to notify selected users (e.g. the client’s case manager, or the client’s care team) if the eligibility query comes back as ineligible. An eligibility report is also available.

TREAT system features integrate with Change Healthcare such that updated statuses on the processing of the claims, and any rejections, denials or other messages back from the payers are displayed within TREAT for each individual claim. Additionally, Change Healthcare offers a customer portal as part of this solution, to review claim statuses, submissions and reconciliations.

TREAT includes an eligibility verification module that is linked with Change Healthcare to submit insurance validation requests to the payer using standard HIPAA 270/271 messaging. The eligibility module is integrated within the TREAT system, via the client’s insurance page.

The Eligibility module allows the user to submit a real-time Health Benefit Plan Coverage request to the selected insurance company(ies). The user can opt to request coverage for specific procedure codes only, or to do a generate eligibility request, and to optional enter specific coverage dates.

All existing queries are tracked, and a history of queries and their results can be viewed at any time.