EDI is more prevalent in healthcare than in any other industry, yet EDI specifications for healthcare are some of the most challenging and opaque standards to understand.

The format, commonly known as X12 HIPAA, is captured in a series of PDFs that are up to 700 pages long. These PDFs aren't available to the general public and they don't provide machine-readable schemas for parsing, generating, or validating files. These challenges have made working directly with X12 HIPAA transactions out of reach for all but the largest companies - until now.

We are excited to announce the availability of Stedi's X12 HIPAA guides, a free catalog of X12 HIPAA specifications that make it easier to understand, test, and translate healthcare EDI.

EDI in Healthcare

In 1996, the Healthcare Insurance Portability and Accountability Act (HIPAA) required that the United States Department of Health and Human Services (HHS) establish national standards for electronic transactions so that health information could be transmitted electronically. Essentially, HIPAA mandated the use of EDI.

HHS ultimately adopted the X12 standard, which was already in use throughout retail, supply chain, and other industries. While the X12 standard was extremely comprehensive, it was also extremely flexible, so HHS created a much narrower, opinionated subset of X12: X12 HIPAA.

With few exceptions, all HIPAA covered entities must support electronic transactions that conform to the X12 HIPAA format. Covered entities include health plans, healthcare clearinghouses, and healthcare providers who accept payment from health plans.

User-friendly, machine-readable X12 HIPAA specifications

The EDI Guide Catalog now has Stedi guides for every X12 HIPAA transaction set. Stedi guides are interactive, machine-readable EDI specifications that let you instantly validate EDI test files.

Validate and debug EDI files

Each guide's EDI Inspector automatically identifies errors in EDI test files, including missing or wrong codes, incorrect formatting, and invalid segments. EDI Inspector runs completely in your browser and doesn't send EDI payloads to Stedi, so you can debug production data without data privacy concerns.

View accurate samples

Each guide contains sample transactions that demonstrate valid usage patterns. You can add samples to EDI Inspector, edit them, and download the result to share with collaborators and trading partners.

Parse and generate compliant EDI

You can import any X12 HIPAA guide directly into your Stedi account and customize it to fit your use case. If you need to integrate X12 HIPAA parsing and generation into your workflows, you can use Stedi Core to programmatically validate against any X12 HIPAA guides and generate X12 EDI that conforms to the specifications.

Build a healthcare EDI integration

We're incredibly excited to make X12 HIPAA specifications accessible to businesses of any size so they can easily build healthcare integrations.

"Stedi’s X12 HIPAA guides are a great way to skip the traditional back-and-forth of PDF guides and sample files. We have been able to cut implementation fees with some partners by five-figure amounts because we can generate valid data so quickly. Our partners also appreciate that we can handle integrations ourselves."

– Russell Pekala, Co-Founder of Yuzu Health

If you're new to EDI, check out our EDI Essentials documentation. Our experts explain the basics of the EDI format and provide answers to common X12 HIPAA questions.

Book a call with our technical team to learn how you can build an EDI integration using Stedi.