HIPAA X12 to FHIR Conversion Package.

Production-grade HIPAA X12 to FHIR R4 conversion package for on-premises and API deployments. Claims, remittance, eligibility, claim status, enrollment, and premium payment.

Runs on the AnyToAny Engine. 40-200ms processing. FHIR Provenance included for audit traceability.

Want to see input/output? Convert X12 to FHIR with sample data (no PHI).

837 Claims 835 Remittance 270/271 Eligibility 276/277 Status 834 Enrollment 820 Payment FHIR Provenance

CMS-0057-F compliance deadline: January 1, 2027. For 278 Prior Authorization with Da Vinci PAS v2.1.0, see the CMS-0057-F Compliance Suite.

This production X12 to FHIR software is used by payers, TPAs, and clearinghouses to modernize legacy EDI into FHIR R4 APIs. Convert X12 837 claims, 835 remittance, 278 prior authorization, and five other transaction sets on-premises with sub-200ms latency.

Target FHIR R4 Resources

Every conversion produces a validated FHIR R4 Bundle with a Provenance resource for audit trail.

Claim
ClaimResponse
Coverage
ExplanationOfBenefit
Provenance
Patient
Practitioner
Organization
CoverageEligibilityRequest
CoverageEligibilityResponse

Supported HIPAA Transactions

837 Claims (P/I/D)

  • 837 Professional to FHIR Claim Bundle
  • 837 Institutional to FHIR Claim Bundle
  • 837 Dental to FHIR Claim Bundle
  • Provenance included for audit trail

835 Payment/Remittance

  • 835 to FHIR ExplanationOfBenefit
  • 835 to PaymentReconciliation
  • Line-level detail preservation

270/271 Eligibility

  • 270 to CoverageEligibilityRequest
  • 271 to CoverageEligibilityResponse
  • Coverage resource generation

276/277 Claim Status

  • 276/277 to FHIR claim status resources
  • Configurable mapping (Claim/ClaimResponse)
  • Real-time status tracking

834 Enrollment

  • 834 to FHIR Coverage
  • Member enrollment/disenrollment
  • Dependent and subscriber handling

820 Premium Payment

  • 820 to FHIR payment resources
  • PaymentNotice/PaymentReconciliation
  • Remittance detail preservation

Want to see real input and output? Convert X12 to FHIR with sample data (no PHI). Or explore the full Live Sandbox.

Performance Benchmarks

Designed for real-time API use cases. Benchmark latencies compatible with healthcare integration workflows.

Transaction Avg Time Throughput
270/271 Eligibility40-60ms1,500+/sec
837 Claims80-150ms800+/sec
835 Remittance100-200ms600+/sec
276/277, 834, 82050-100ms1,000+/sec

Don't have X12 278 infrastructure? Use the RMap Module to generate Da Vinci PAS FHIR bundles directly from a simple CSV format. Same compliance output, simpler implementation.

Licensing

AnyToAny Engine

Required. Core conversion engine providing the single-pass architecture, IFD/OFD processing, and runtime environment.

HIPAA X12 to FHIR Package

This package. 837, 835, 270/271, 276/277, 834, 820 to FHIR R4 conversion with Provenance.

RMap Module

Alternative. Skip X12 complexity. Generate Da Vinci PAS FHIR bundles from CSV -- same compliance output, simpler implementation.

Modular pricing. The AnyToAny Engine is the core product required for all conversions. Each module is licensed separately based on your requirements. For 278 Prior Authorization, see the CMS-0057-F Compliance Suite.