Redix HIPAA Package
The HIPAA 5010 X12 toolkit for the Redix engine: transaction set definitions, validation rules, pre-defined maps, and the GUI Mapper for building and testing your own maps. X12 4010 and 5010 releases (specific implementation guides confirmed in your evaluation), plus legacy NSF, UB, and HCFA formats.
- 837 · 835 · 834 · 820
- 270/271 · 276/277 · 278
- Runs on the AnyToAny Engine
Need FHIR R4 output? Convert HIPAA X12 to FHIR R4 bundles with the HIPAA X12 to FHIR Package. For CMS-0057-F prior authorization (Da Vinci PAS), see the CMS-0057-F Compliance Suite.
Definitions, validation, maps, and authoring tools
HIPAA data definitions
Structures for the HIPAA 5010 transaction sets, with segment definitions and the validation rules the engine applies to them.
Validation
Syntax and inter-segment checks for every transaction, and balancing for 837, 835, and 820, with 999 and TA1 acknowledgments. The same checks power the HIPAA X12 Validator.
Pre-defined maps
Ready-to-use mappings between HIPAA X12 and legacy HCFA and UB formats, editable in the GUI Mapper.
GUI Mapper with EDI authoring
A point-and-click map designer with drag-and-drop mapping and a side-by-side translation view. More about the GUI Mapper.
The HIPAA 5010 portfolio
| Transaction | Code | Description |
|---|---|---|
| Claims | 837 | Professional, institutional, and dental claim submission |
| Remittance | 835 | Claim payment and remittance advice |
| Eligibility | 270/271 | Eligibility and benefit inquiry and response |
| Claim status | 276/277 | Claim status request and response |
| Prior authorization | 278 | Health care services review |
| Enrollment | 834 | Benefit enrollment and maintenance |
| Payment | 820 | Premium payment |
The table lists the common transactions. The package includes definitions and validation assets for the HIPAA 5010 transaction sets, plus legacy NSF, UB, and HCFA support.
Map reports and auditing
Map reports with sort and filter tools, so a reviewer can audit what each map does.
Integration
Call the engine from a REST API, in batch, or in-process through the language bindings.
Try HIPAA conversions on synthetic data
The tools run in your browser without a local installation, on built-in synthetic samples; some ask you to register first, and testing your own files requires an evaluation key. Do not upload PHI.
How the package is licensed
AnyToAny Engine
Required. The core engine: single-pass processing, IFD/OFD definitions, and the runtime.
HIPAA Package
This package. HIPAA 5010 definitions, validation rules, pre-defined maps, and the GUI Mapper.
HIPAA X12 to FHIR
Optional. Convert HIPAA X12 transactions to FHIR R4 bundles.
The AnyToAny Engine is required for every conversion; each module is licensed separately. For CMS-0057-F, see the CMS-0057-F Compliance Suite.
Talk to us about your X12 workflow
Tell us your transactions, volumes, and trading partners. We recommend the modules you need and show a working path on a de-identified sample.