Accelerate Healthcare EDI — Build, Automate & Scale
edifunctions delivers end-to-end healthcare EDI solutions — 837P/I/D claims processing, CMS-1500 & UB-04 conversion, real-time eligibility, remittance automation, and clearinghouse connectivity. HIPAA-compliant. Zero downtime.
Complete Healthcare EDI Services
From claims submission to clearinghouse connectivity — every healthcare EDI workflow, fully managed.
Professional Claims (837P)
CMS-1500 to EDI 837P conversion, OCR scanning, HIPAA validation, and electronic submission to payers and clearinghouses.
Institutional Claims (837I)
UB-04 to EDI 837I processing — hospital and facility claims conversion, validation, and multi-payer submission.
Dental Claims (837D)
ADA dental form to EDI 837D conversion, CDT code validation, OCR, and direct dental payer connectivity.
Eligibility & Benefits (270/271)
Real-time and batch eligibility verification — confirm patient coverage, co-pays, and deductibles before every visit.
Claim Status (276/277)
Automated claim status inquiries and responses — track every claim from submission to adjudication in real-time.
Remittance (835/ERA)
Electronic remittance advice processing — automated payment posting, denial management, and reconciliation.
EDI Environment & Integration
PMS/EMR/EHR integration, clearinghouse & payer connectivity, database mapping, and custom format translation.
Full EDI Lifecycle
End-to-end: parsing, validation, mapping, generation, acknowledgements (TA1/997/999), and compliance auditing.
Support & Maintenance
24/7 monitoring, partner onboarding, schema updates, troubleshooting, performance tuning, and HIPAA compliance support.
Every Healthcare Claim, Fully Automated
We process and convert all major healthcare claim types with full HIPAA 5010 compliance — zero manual intervention.
CMS-1500 / 837P
Professional claims for physicians, providers, and outpatient services.
UB-04 / 837I
Institutional claims for hospitals, skilled nursing, and inpatient facilities.
ADA / 837D
Dental claims for dental offices and oral surgery providers.
Eligibility (270/271)
Real-time and batch eligibility verification with insurance payers.
Claim Status (276/277)
Track claims from submission through adjudication — automated inquiries and responses.
Remittance (835/ERA)
Electronic remittance advice processing, payment posting, and reconciliation.
Translate Between Any Format & EDI
Bi-directional format translation — convert any data format to healthcare EDI and back, instantly.
EDI → Any Format
Any Format → EDI
Flexible Deployment Models
Run edifunctions wherever your infrastructure lives — cloud, on-prem, containerized, serverless, or embedded via .NET SDK.
Cloud-Based API
Fully managed, pay-per-use healthcare EDI processing with auto-scaling and high availability.
On-Premise API
Self-hosted API server for HIPAA-compliant, air-gapped, or high-security environments.
Docker Image
Containerized deployment for Kubernetes, Docker Compose, or any container orchestration platform.
Lambda / Serverless
Serverless EDI processing on AWS Lambda, Azure Functions, or Google Cloud Functions.
.NET SDK / NuGet
Embed healthcare EDI processing directly in your C# / .NET applications via NuGet package.
Hybrid Deployments
Cloud API + local DB, local processing + cloud validation, on-prem connector + cloud monitoring.
Built for .NET Developers
edifunctions provides a powerful .NET SDK — install via NuGet and start processing healthcare EDI in minutes. Full API documentation included.
- C# / .NET / .NET Core / ASP.NET
- NuGet package — install in seconds
- In-process EDI parsing & generation
- Full HIPAA 5010 transaction support
- REST API also available
dotnet add package edifunctions
// Parse an 837P claim in C#
using edifunctions;
var parser = new EdiParser();
var claim = parser.Parse837P(ediContent);
// Access structured claim data
var patientName = claim.Patient.Name;
var diagnosis = claim.Diagnosis[0].Code;
var totalCharge = claim.TotalCharge;
From Consultation to Go-Live
A proven 4-step process to get your healthcare EDI environment running smoothly — with zero disruption to your practice.
Consult & Discover
We analyze your EDI requirements, payer relationships, existing systems, and design a tailored solution architecture.
Build & Integrate
We build connectors, configure clearinghouse connections, set up claim mappings, and integrate with your PMS/EHR.
Test & Certify
End-to-end testing with payers and clearinghouses, HIPAA certification, and production-ready validation.
Go Live & Scale
Production deployment with 24/7 monitoring, ongoing support, partner onboarding, and performance optimization.