X12 healthcare EDI integration

X12 EDI integration for eligibility, claims, and payer workflows

Connect healthcare applications, billing workflows, and payer transactions without forcing your product and operations teams to become EDI specialists.

A technical question or early-stage idea is enough to start. No budget or timeline is required.

270/271 eligibility837 claims835 remittance276/277 claim status
Capabilities

From technical discovery to production support

We can own a focused piece of work or stay with the implementation from architecture through go-live and support.

Eligibility and benefits

Build 270/271 workflows that collect the right inputs, submit requests, normalize responses, and expose useful coverage information.

  • Real-time and batch eligibility
  • Payer and provider identifier handling
  • Normalized benefits and error responses

Claims and remittance

Connect claim creation and payment workflows with validation, status visibility, and operational reconciliation.

  • 837 professional and institutional claim workflows
  • 835 remittance ingestion and mapping
  • Claim status and acknowledgment handling

Mapping and validation

Translate between product data models and X12 transactions while preserving the rules operations teams depend on.

  • Loop, segment, and code-set mapping
  • Companion-guide requirement review
  • Validation and exception classification

APIs and operations

Wrap EDI transactions in maintainable application workflows with monitoring and supportable failure handling.

  • Stedi API and webhook integration
  • Queues, retries, and idempotency
  • Reconciliation, alerts, and support runbooks
Typical deliverables

A useful handoff, not a black box

Your team gets the implementation details, operational visibility, and documentation needed to own or support what goes live.

  • Workflow and transaction architecture covering applications, payers, clearinghouses, and operational ownership
  • X12 mapping specifications tied to your product or billing data model
  • Implemented transactions with validation, acknowledgments, exception handling, and test scenarios
  • Monitoring, reconciliation, support procedures, and documentation for production operations
Frequently asked questions

Questions teams ask before starting

Which healthcare X12 transactions do you support?+

Common integrations include 270/271 eligibility, 837 claims, 835 remittance, and 276/277 claim status. We scope each project around the systems, payers, clearinghouse or API platform, and operational workflow involved.

Can you make X12 data easier for our application to use?+

Yes. We can map X12 loops and segments into an application-friendly data model, normalize responses across payers, and design APIs or events that keep EDI complexity away from product-facing code.

Can you implement X12 workflows with Stedi?+

Yes. Globalesm is a listed Stedi implementation partner and can help with transaction design, API integration, webhooks, mappings, testing, exceptions, reconciliation, and production support.

How do you test healthcare EDI integrations?+

Testing typically covers representative transactions, required identifiers and code sets, payer-specific scenarios, validation failures, acknowledgments, duplicate handling, retries, reconciliation, and the operational response to exceptions.

Tell us what needs to work.

Send a plain message about the system, interface, migration, or support question. We will route it to the right person.