Convert X12 to FHIR R4: Try with 837, 835, 278 Sample Data

Turn HIPAA X12 transactions into FHIR R4 bundles in seconds, see the output immediately.

Sample data only, do not paste PHI.
Try X12 → FHIR Demo (sample data) Schedule a 30-min Technical Consult

What This Tool Does

Redix converts HIPAA X12 EDI transactions into validated FHIR R4 JSON bundles. The converter handles six transaction families used across claims, eligibility, prior authorization, enrollment, and payment workflows.

  • 837 Claims (Professional, Institutional, Dental) → FHIR Claim resources
  • 835 Payment/Remittance → ExplanationOfBenefit
  • 278 Prior Authorization → Da Vinci PAS bundles (CMS-0057-F aligned)
  • 270/271 Eligibility → CoverageEligibilityRequest/Response
  • 276/277 Claim Status → Task resources
  • 834 Enrollment → Coverage and Patient resources

Every output bundle includes FHIR R4 validation and optional Provenance resources. Processing is handled by the Redix native engine, designed for high-throughput healthcare transformation workloads.

Supported X12 Transactions

837 Professional

Health Care Claim: Professional

→ Claim, Patient, Practitioner, Coverage

837 Institutional

Health Care Claim: Institutional

→ Claim, Patient, Organization, Coverage

837 Dental

Health Care Claim: Dental

→ Claim, Patient, Practitioner, Coverage

835 Remittance

Health Care Claim Payment/Advice

→ ExplanationOfBenefit, PaymentReconciliation

278 Prior Auth

Prior Authorization Request/Response

→ Da Vinci PAS Bundle (CMS-0057-F)

270/271 Eligibility

Eligibility Inquiry and Response

→ CoverageEligibilityRequest/Response

276/277 Claim Status

Claim Status Inquiry and Response

→ Task, Claim, Patient

834 Enrollment

Benefit Enrollment and Maintenance

→ Coverage, Patient, Organization

Example: 837 Professional → FHIR Bundle

Here's what the converter produces from a standard 837P claim:

Sample Input (X12 837 Professional)

ISA*00*          *00*          *ZZ*123456789012345*ZZ*123456789012345*030101*1253*^*00501*987654321*1*T*:
GS*HC*123456789012345*123456789012345*19991231*0802*123456789*X*005010X222
ST*837*0021*005010X222
BHT*0019*00*244579*20061015*1023*CH
NM1*41*2*PREMIER BILLING SERVICE*****46*TGJ23
NM1*40*2*KEY INSURANCE COMPANY*****46*66783JJT
HL*1**20*1
...
Truncated for readability. Full sample data included in the demo.

Sample Output (FHIR R4 JSON Bundle)

{
  "resourceType": "Bundle",
  "type": "collection",
  "timestamp": "2006-10-15T10:23:00Z",
  "entry": [
    {
      "resource": {
        "resourceType": "Claim",
        "status": "active",
        "use": "claim",
        "type": {
          "coding": [{
            "system": "http://terminology.hl7.org/CodeSystem/claim-type",
            "code": "professional"
          }]
        },
        "patient": {"reference": "Patient/a783d7c1-..."},
        "insurer": {"reference": "Organization/5a59e8ca-..."},
        "diagnosis": [
          {"sequence": 1, "diagnosisReference": {"reference": "Condition/..."}}
        ],
        "item": [{
          "sequence": 1,
          "productOrService": {
            "coding": [{"system": "http://www.ama-assn.org/go/cpt", "code": "99213"}]
          },
          "unitPrice": {"value": 40, "currency": "USD"}
        }],
        "total": {"value": 100, "currency": "USD"}
      }
    },
    {"resource": {"resourceType": "Patient", "name": [{"family": "SMITH", "given": ["JANE"]}], "birthDate": "1943-05-01"}},
    {"resource": {"resourceType": "Organization", "name": "KEY INSURANCE COMPANY"}},
    {"resource": {"resourceType": "Coverage", "status": "active"}},
    {"resource": {"resourceType": "Condition", "code": {"coding": [{"system": "http://hl7.org/fhir/sid/icd-9-cm", "code": "0340"}]}}}
  ]
}
Simplified for readability. Actual output includes full references, identifiers, and optional Provenance resources.

Deployment Options

  • Online demo: Try immediately with Redix sample data. Testing your own de-identified files requires an evaluation key.
  • REST API: Integrate via HTTP endpoints with Python, Node.js, C#, or Java SDKs (Developer Portal)
  • On-premises engine: Native C engine, no JVM overhead. PHI stays in your infrastructure.

Frequently Asked Questions

Which X12 transaction types can Redix convert to FHIR R4?
Redix converts 837 Professional, Institutional, and Dental claims to FHIR Claim resources; 835 remittance to ExplanationOfBenefit; 278 prior authorization to Da Vinci PAS bundles; 270/271 eligibility to CoverageEligibilityRequest/Response; 276/277 claim status to Task resources; and 834 enrollment to Coverage. Output is generated as FHIR R4 JSON bundles and can be validated as part of the implementation workflow.
What FHIR version does the converter output? Can you map to specific Implementation Guides?
All output is FHIR R4 (4.0.1). For 278 prior authorization, Redix supports Da Vinci PAS-aligned mapping for CMS-0057-F prior authorization workflows. Exact implementation-guide and payer-specific requirements should be confirmed during the evaluation.
Does the online demo accept real patient data (PHI)?
No. The online demo is for sample and synthetic data only, do not paste PHI. For production use with real patient data, Redix deploys on-premises within your environment, ensuring PHI never leaves your infrastructure.
How does X12 278 prior auth relate to FHIR PAS?
Redix provides bidirectional X12 278 and FHIR PAS conversion, enabling organizations to maintain existing X12 278 workflows while meeting CMS-0057-F FHIR API requirements. This dual-stack approach lets you bridge the transition period without replacing your current infrastructure. See the PAS tool for the full workflow.
Is this available as an API or on-premises software?
Yes, both. Redix offers a REST API for cloud integration and an on-premises native C engine for environments where data must stay in-house. The engine is a native C implementation with no JVM overhead. Python and Node.js SDKs are also available.
How accurate is the X12 to FHIR mapping?
Out-of-box mapping coverage is typically substantial, but exact coverage depends on transaction type, payer conventions, and site-specific requirements.

Need this running in your environment?

Run the same Redix engine in your own environment (Docker or on-prem). No PHI leaves your system.

Request Technical Evaluation

We will help you choose the right evaluation path for sample testing, API testing, or deployment in your own environment.

Used in production by large healthcare organizations, including Fortune 500 companies. Trusted for over a decade in healthcare data integration.

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