Claims Management and Repricing Services

TRX – Transaction Repricing & eXchange

The EHS PPO Network is powered by our highly customizable TRX (Transaction Repricing & eXchange) service architecture. TRX is a powerful open-architecture, claims management solution designed to integrate well with client specific claims flow requirements and leading claims adjudication systems such as RIMS, and ERISCO. Through the use of TRXpass, TRXchex, and TRXport, our clients benefit from having a highly automated and secure claims repricing, reporting, and transactional routing solution that’s well integrated with their business. 

TRXpass – Web Repricing

Clients can access the full function of the TRX system and reprice claims via a secure web connection at www.ehsppo.com. TRXpass is an easy to use, claims repricing solution which provides instant repricing and EOR access on a per claim basis. Learn more about repricing HCFA and UB-92 claims on-line or request a demonstration by contacting Sales & Marketing Department

TRXchex – Web Imaging & Claims Status

Along with TRXpass for web based repricing, clients can access a copy of the original claim images and Explanation of Repricing (EOR) using TRXchex, for immediate claims adjudication or for Customer Service related issues. Learn more about TRXchex and TRXpass or request a demonstration by contacting our Sales & Marketing Department

TRXport - Electronic Data Interchange (EDI) repricing

Based on our TRX open architecture claims management solution, EHS utilizes TRXport for secure transmission and receive claims data from our clients. Electronic Data Interface (EDI) is a standard transaction set (supporting both HCFA and UB-92 claims data), that allows clients to submit and receive batches of claims based on the X12 837/5010 claim transactions format. EDI based transactions are automatically matched with EHS provider network, processed by the TRX claims management system, and returned electronically in the ASC X12 837/5010 format. Learn more about TRXport by contacting our Sales & Marketing Department

Mail Room Services – For paper claim handling and repricing

Yes, in this age of electronic transmissions there are still paper claims!  At the EHS Claims Processing Center we staff our own full-function mail handling facility to manage paper-based claims. All paper claims are scanned and imaged using OCR/ICR technology, then fully validated for data integrity before submitting for automated repricing using TRX. Completed claims can be distributed with the Explanation of Repricing (EOR), in paper or returned in a standard or custom electronic format. Imaged claims and the EOR can be viewed over the web using TRXchex. Learn more about Mail Room Services by contacting our Sales & Marketing Department