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HIPAA X12 EDI Validation and Compliance

SNIP Types 1-7 Support: Greater Accuracy & Quality

Take a deep dive and see how PilotFish offers a superior solution and a far better value proposition than other X12 EDI solution suites. A highly-rated modern solution, PilotFish provides much more robust validation and HIPAA EDI compliance checks. Unlike most other X12 EDI validation products, PilotFish supports SNIP Type 1-7 (SNIP Levels) with more built-in features and greater accuracy at every point.

Our value proposition is why we have X12 EDI clients in virtually every area of the healthcare industry – Providers, Insurance Payers, TPAs, Clearinghouses, HIEs, EMR vendors, Pharmacies and Pharmacy Benefit Managers (PBMs), Data Analytics, Revenue Cycle and Recovery Providers, Solution Providers, etc. PilotFish offers users ease-of-use, a short learning curve and outstanding performance.

10-Second Summary Demonstrates PilotFish Superiority

  • In SNIP Type 1-3, rules are automatically derived directly from the implementation guide schema for a one-to-one match, ensuring syntax and standards consistency.
  • For SNIP Type 4, others validate only a partial set of semantic rules. PilotFish validates a much more complete set of semantic rules as defined in the HIPAA X12 EDI implementation guides.
  • For SNIP Type 5, PilotFish validates against all external codes in the database, flags errors for remediation as well as regularly updates and maintains codes for you.
  • For SNIP Type 6-7, PilotFish offers the ability to customize codes to your own business type and needs.
  • PilotFish provides the ability to test every transaction sent or received to validate transaction compliance.
  • PilotFish provides built-in extensive X12 EDI expertise to help you avoid compliance risks.

In short, PilotFish is the only solution that you’ll ever need to validate healthcare HIPAA X12 EDI data.

PilotFish Suite
PilotFish’s stand-alone rules-driven EDI SNIP Validation Processor handles validation of SNIP Types 1-7 (SNIP Levels).
SNIP Type 1-3 Validation
Automatically generates rules derived from the X12 implementation guide schema for a one-to-one match. (Enforces syntax consistency.)
SNIP Type 1-3 validations efficiently run for all inbound and outbound transactions.
Validation is done on-premise not requiring PHI to be sent to a 3rd party site for validation.
SNIP Type 4 Validation
Validates a very robust set of semantic (situational) rules defined in the implementation guides.
SNIP Type 5 Validation
Has all external codes in a database
Checks for valid codes in a database
Regular code updates and maintenance
Flags errors to report and address them
PilotFish offers SNIP Types 1-3 out of the box and SNIP Types 4-5 as an add-on.
SNIP Type 6-7 Validation
Ability to customize codes to your own business type and needs
PilotFish offers professional services to facilitate SNIP Type 6-7.
Compliance
HIPAA 5010 compliant
HIPAA 7030 compliant (including future versions)
Testing
Ability to test every transaction sent or received to validate HIPAA X12 EDI transaction compliance
Allows full file testing vs sample file testing
Testing integrated with transformation
Comprehensive Integration Support
Integration Engine
Supports X12 EDI formats as well as HL7, CDA, FHIR, NCPDP, JSON, XML, Flat Files, Delimited Files, XLS, PDF, Binary, DICOM, SQL
Built-in graphical drag & drop transformation tool
Inline end-to-end testing component
Real-time Dashboard
Architecture
Utilizes industry standard methodology for processing transactions
XML used for data conversion and W3C compliant XSLT for data manipulation
Designed to be extensible
Ability for use beyond just EDI integration
Deployment
On Premise
Cloud
On-Demand
Usability
Graphical IDE (no coding required)
Designed to allow BAs to do up to 80-90% of the work
Architected for easy customization

In total, PilotFish delivers features and modules that strip away the technical complexity of parsing, validating, mapping and producing X12 EDI files. With PilotFish, teams across all areas only need to learn and use one solution to:

  • Parse any X12 Transaction as XML · Validate SNIP Types 1-7 (SNIP Levels) with built-in rules-driven EDI SNIP Validation Processor
  • Review and Map XML using human-readable (and easily understood) “Friendly Names”
  • Automatically Convert to human-readable text all encountered compact-consistent code values
  • Browse and Search the hierarchy of any X12 EDI Message during data mapping
  • Produce ANY X12 Transaction from a corresponding XML representation
  • Scale to Interface Large X12 Transactions through parallelized batch processing
  • Leverage support for handling both non-HIPAA and HIPAA 5010 transactions

Leverage More Built-In Components, Features and Value with PilotFish

PilotFish can go beyond the validation of X12 EDI transaction data to provide your organization with the functionality to transform and map it to or from any other application. You get a comprehensive validation and data integration solution for the same price.

Give us a call at 813 864 8662 or click the button to email us. Schedule a demo so we can walk you through how we can meet your needs for any use case or scenario. PilotFish will reduce your upfront investment, deliver more value and generate a higher ROI like we have done for 100s of users.

HL7 is the registered trademark of Health Level Seven International. 
X12, chartered by the American National Standards Institute for more than 35 years, develops and maintains EDI standards and XML schemas.

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