HL7 & CDA HIPAA X12 & RMap API

Select Conversion Direction:

Select X12 Transaction Type:

PRIOR AUTHORIZATION (CMS MANDATED)

278 Prior Authorization Request CMS REQUIRED

Request prior authorization for medical services (Da Vinci PAS v2.1)

278 Prior Authorization Response CMS REQUIRED

Receive authorization approval/denial (Da Vinci PAS v2.1)

ELIGIBILITY & BENEFITS

270 Eligibility Inquiry

Check patient eligibility and coverage

271 Eligibility Response

Receive eligibility and benefit information

CLAIM STATUS

276 Claim Status Inquiry

Request status of submitted claims

277 Claim Status Response

Receive claim processing status

CLAIMS SUBMISSION

837 Professional Claims

Submit professional/physician claims

837 Institutional Claims

Submit hospital/facility claims

ENROLLMENT & PAYMENT

834 Enrollment

Benefit enrollment and maintenance

835 Remittance

Payment and remittance advice

Select RMap Transaction Type:

PRIOR AUTHORIZATION (CMS MANDATED)

RMap 278 Prior Authorization Request CMS REQUIRED NEW

Convert RMap 5 278 Request to Da Vinci PAS FHIR Bundle - Alternative to X12 EDI for Prior Authorization

Why Use RMap Format?

For customers already using RMap: If you're using RMap 834 for enrollment or other RMap transactions, you can leverage the same familiar format for Prior Authorization.

Simpler structure: RMap's field-delimited format is easier to generate and debug than X12 EDI.

Same FHIR output: Generates identical Da Vinci PAS-compliant FHIR bundles as the X12 converter.

Output: FHIR R4 Bundle with Claim, Patient, Organization, Practitioner, Coverage, Condition resources

Select FHIR to X12 Conversion:

PRIOR AUTHORIZATION (CMS MANDATED)

FHIR ClaimResponse → X12 278 Response CMS REQUIRED

Convert Da Vinci PAS ClaimResponse (with item[] arrays) to X12 278 Prior Authorization Response

About FHIR to X12 Conversion

Input: FHIR ClaimResponse resource (standalone or Bundle with references)

Output: X12 005010X217 278 Response transaction

Features:

Bundle resolution (resolves Patient/Practitioner/Organization references)
Field validation with auto-truncation to X12 limits
PAS extension extraction (itemTraceNumber, itemPreAuthPeriod, reviewAction)
Generates valid X12 278 Response with all required segments

Upload File
Paste X12

Upload HIPAA X12 Transaction

Click to browse or drag & drop your .x12, .txt, .edi file

Supported: 278, 270, 271, 276, 277, 834, 835, 837P, 837I

Paste X12 Content:

Processing Status:

Validating X12 transaction

Converting to FHIR

Conversion complete

Conversion Results

Transaction Type

FHIR Resources

Coverage

Processing Time

HIPAA X12 to FHIR REST API

Integrate HIPAA X12 to FHIR conversion into your applications

API Base URL: https://demo.redix.com/api/hipaa
X12→FHIR API supports all 10 HIPAA transaction types (278, 270, 271, 276, 277, 834, 835, 837 Prof, 837 Inst). FHIR→X12 API supports 278 Response only.

Description:

Load sample HIPAA X12 files for testing and development.

Supported Transaction Types:

278_REQUEST - Prior Authorization Request
278_RESPONSE - Prior Authorization Response
270 - Eligibility Inquiry
271 - Eligibility Response
276 - Claim Status Inquiry
277 - Claim Status Response
834 - Benefit Enrollment
835 - Payment/Remittance
837_PROFESSIONAL - Professional Claims
837_INSTITUTIONAL - Institutional Claims

Example Request:

curl -X GET https://demo.redix.com/api/hipaa/sample/278_REQUEST

Response Format:

{
  "success": true,
  "content": "ISA*00*          *00*          *ZZ*SUBMITTERS ID  *ZZ*RECEIVERS ID   ...",
  "transaction_type": "278_REQUEST",
  "filename": "H_5010_278Req.278REQ"
}

Description:

Convert HIPAA X12 EDI transactions to FHIR R4 bundles. Supports automatic transaction type detection or manual specification.

Request Body:

{
  "content": "ISA*00*...",           // Required: X12 EDI content
  "transaction_type": "278_REQUEST", // Optional: Will auto-detect if not provided
  "filename": "transaction.x12"     // Optional: For logging/tracking
}

Example Request (cURL):

curl -X POST https://demo.redix.com/api/hipaa/convert \
  -H "Content-Type: application/json" \
  -d '{
    "content": "ISA*00*          *00*          *ZZ*SUBMITTERS ID  *ZZ*RECEIVERS ID   *250101*1200*^*00501*000000001*0*P*:~GS*HS*SUBMITTERS CODE*RECEIVERS CODE*20250101*1200*1*X*005010X217~ST*278*0001*005010X217~...",
    "transaction_type": "278_REQUEST"
  }'

Example Request (Python):

import requests

x12_content = """ISA*00*          *00*          *ZZ*SUBMITTERS ID  ..."""

response = requests.post(
    'https://demo.redix.com/api/hipaa/convert',
    json={
        'content': x12_content,
        'transaction_type': '278_REQUEST'
    }
)

result = response.json()
if result['success']:
    fhir_bundle = result['fhir']
    print(f"✓ Converted! FHIR Bundle has {len(fhir_bundle.get('entry', []))} resources")
else:
    print(f"✗ Error: {result['error']}")

Example Request (JavaScript):

const x12Content = `ISA*00*          *00*          *ZZ*SUBMITTERS ID  ...`;

fetch('https://demo.redix.com/api/hipaa/convert', {
    method: 'POST',
    headers: { 'Content-Type': 'application/json' },
    body: JSON.stringify({
        content: x12Content,
        transaction_type: '278_REQUEST'
    })
})
.then(res => res.json())
.then(result => {
    if (result.success) {
        console.log('✓ FHIR Bundle:', result.fhir);
    } else {
        console.error('✗ Error:', result.error);
    }
});

Response Format:

{
  "success": true,
  "transaction_type": "278_REQUEST",
  "transaction_name": "278 Prior Authorization Request",
  "fhir": {
    "resourceType": "Bundle",
    "type": "collection",
    "entry": [
      {
        "resource": {
          "resourceType": "Claim",
          "id": "claim-1",
          "status": "active",
          "type": { "coding": [{ "code": "institutional" }] },
          ...
        }
      },
      ...
    ]
  },
  "x12_content": "ISA*00*...",
  "stats": {
    "resource_count": 5,
    "conversion_time_ms": 234
  }
}

Error Response:

{
  "success": false,
  "error": "Unknown or unsupported transaction type: 999"
}

Authentication:

The demo API is currently open for testing purposes. Production deployments should implement appropriate authentication (API keys, OAuth 2.0, etc.).

Rate Limits:

Demo environment limits:

100 requests per minute per IP
Maximum file size: 10 MB
Request timeout: 120 seconds

Best Practices:

Always specify transaction_type when possible to avoid auto-detection overhead
Use proper error handling for network failures and conversion errors
Validate X12 content before sending to the API
Store conversion results for audit purposes

HIPAA Compliance Note: This demo environment is for testing only. Do not send PHI (Protected Health Information) to demo.redix.com. For production deployments with real patient data, contact Redix for enterprise solutions.

CMS-0057-F Compliant | Da Vinci PAS v2.1 Ready

HIPAA X12 & RMap to FHIR Converter

CMS MANDATE: Da Vinci Prior Authorization API (FHIR)

Select Conversion Direction:

Select X12 Transaction Type:

Select RMap Transaction Type:

Why Use RMap Format?

Select FHIR to X12 Conversion:

About FHIR to X12 Conversion

Upload HIPAA X12 Transaction

Processing Status:

Error

Conversion Results

Transaction Type

FHIR Resources

Coverage

Processing Time

HIPAA X12 to FHIR REST API

Description:

Supported Transaction Types:

Example Request:

Response Format:

Description:

Request Body:

Example Request (cURL):

Example Request (Python):

Example Request (JavaScript):

Response Format:

Error Response:

Authentication:

Rate Limits:

Best Practices:

HIPAA X12 & RMap to FHIR Converter

CMS MANDATE: Da Vinci Prior Authorization API (FHIR)

Select Conversion Direction:

Select X12 Transaction Type:

Select RMap Transaction Type:

Why Use RMap Format?

Select FHIR to X12 Conversion:

About FHIR to X12 Conversion

Upload HIPAA X12 Transaction

Processing Status:

Error

Conversion Results

Transaction Type

FHIR Resources

Coverage

Processing Time

HIPAA X12 to FHIR REST API

GET /api/hipaa/sample/{transaction_type}

Description:

Supported Transaction Types:

Example Request:

Response Format:

POST /api/hipaa/convert

Description:

Request Body:

Example Request (cURL):

Example Request (Python):

Example Request (JavaScript):

Response Format:

Error Response:

Authentication & Rate Limits

Authentication:

Rate Limits:

Best Practices: