Consultation Services FAQ

• CMS-0057-F readiness: assessment, gap analysis, implementation guidance, go-live support
• FHIR transformation: HIPAA X12 to FHIR, HL7 v2.x to FHIR, and CDA to FHIR projects
• Custom mapping: extending the pre-defined maps with your organization's fields and rules
• PAS enablement with RMap: for organizations without X12 278 infrastructure
• Legacy migration: EDI and HL7 migration support

Backed by more than 30 years of healthcare EDI and data transformation work (founded 1994). That production history belongs to the Redix engine and its EDI modules. FHIR and PAS work is implementation and evaluation help built on newer conversion components and the demonstrated workflows, and CDA to FHIR uses open-source-based foundation components.

• Discovery and assessment (about 1 day of consulting): readiness assessment, gap analysis report, architecture recommendations, EDI infrastructure review
• Professional services (about 5 days of consulting): FHIR implementation support, custom mapping, Da Vinci PAS setup, database schema design
• CMS-0057-F readiness (about 10 days of consulting): prior authorization implementation support, X12 to FHIR conversion configuration, the demonstrated API workflows as a starting point, testing and go-live support
• Enterprise: a scoped FHIR/EDI engagement with custom mapping, training sessions, and priority support options defined in your agreement

The day counts are consulting effort, not a promised time to finish. Deliverables, prerequisites, schedule, and included effort are agreed for each engagement.

Four phases:

• 1. Readiness Assessment — understand current infrastructure, data flows, and gaps
• 2. Strategic Planning — design implementation approach and timeline
• 3. Implementation — build, configure, and test
• 4. Go-Live Support — deployment assistance and verification

• HIPAA 5010 and ANSI X12
• UN/EDIFACT
• HL7 v2.x
• FHIR R4, including Da Vinci PAS
• NCPDP
• XML, RMap, and custom flat files

The PAS version and any other profiles (for example US Core) are chosen for each project according to the applicable program, the receiving systems, and your trading partners.

About ten days of consulting effort covering:

• Prior authorization implementation approach (FHIR-only, or FHIR with X12 278)
• Da Vinci PAS setup for the version agreed for your applicable requirements and trading partners
• X12 to FHIR conversion configuration
• The demonstrated API workflows as a starting point for your integration
• Testing and go-live support

CMS-0057-F API requirements generally begin January 1, 2027; timing depends on payer category. Validation against the agreed profiles and payer requirements is part of the engagement. Consulting supports your program; it does not by itself make a payer compliant.

The pre-defined maps cover the standard transactions. Custom mapping adds what your organization needs:

• Organization-specific field transformations
• Custom business logic rules
• Additional field mappings through the GUI Mapper or IFD/OFD configuration

Included in the professional services and enterprise packages, or available on its own.

For organizations without X12 278 infrastructure, Redix consultants set up the RMap to FHIR path. Your system writes prior authorization requests in a defined Redix 278 request layout (RMap), and the configured mapping builds Da Vinci PAS request bundles from it without producing X12 first. It needs the applicable engine, module, and map licenses. Validating the output against the agreed PAS version and the receiving payer's requirements is part of the engagement.

Engagements are conducted remotely, on-site, or as a hybrid of both. On-site availability and travel are agreed for each engagement.

Contact Redix to discuss a Discovery & Assessment. It is typically about a day of consulting effort; its deliverables (such as a readiness report and architecture recommendations), prerequisites, and schedule are agreed first.