Introducing Stedi's X12 HIPAA guides

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.

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

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

Build a healthcare EDI integration

"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