Convert HIPAA claims and remittances to PDF
Generate CMS-1500, UB-04, and ADA J400 claim forms and 835 remittance reports directly from HIPAA X12 transactions. An add-on for the AnyToAny Engine, run on-premises or in Docker, one claim at a time or in batch.
- CMS-1500
- UB-04
- ADA J400
- 835 remittance
- On-premises or Docker
Four standard HIPAA-to-PDF conversions
| Output | Source X12 | Typical use |
|---|---|---|
| CMS-1500 | 837 Professional (5010A1) | Provider review, paper submission, per-claim archiving |
| UB-04 (CMS-1450) | 837 Institutional (5010A2) | Hospital and facility claim review |
| ADA J400 | 837 Dental (5010A2) | Dental claim review and archiving |
| 835 remittance report | 835 (5010A1) | Payment review, finance reporting, payer and provider distribution |
The online converter offers synthetic samples for all four outputs (overview: Claims to PDF online). Each map is a Redix IFD/OFD pair: use it as supplied, or adjust the output definition for field positions, headers, or branding without touching the engine.
Beyond pre-built forms
PDF manipulation
Import, split, and merge existing PDFs. Combine claims into one document or extract specific pages.
Layout control
Configurable positioning of every element, for custom templates and branded documents.
Batch output
One PDF per claim or all claims in one document, with password and permission controls applied at generation.
Need more than a converter?
The Claims-to-PDF Workbench is a Windows add-on installed after the Redix V9 engine with the PDF Module. It converts whole folders of claim files, keeps each one with its original EDI in a searchable local archive, exports audit-support packages, and prints CMS-1500 claims onto preprinted forms or blank paper.
How the module is licensed
AnyToAny Engine
Required. The core engine: single-pass processing, IFD/OFD definitions, and the runtime.
PDF Module
This module. PDF generation, the pre-built HIPAA PDF maps, merge, split, import, and password controls.
HIPAA Package
Recommended. HIPAA X12 support for the 837 and 835 transactions the forms are built from.
The AnyToAny Engine is required for every conversion; each module is licensed separately.
See your claims as PDFs
Try the synthetic samples, then ask us to run your de-identified files through the maps you need.