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Modernize Healthcare EDI with GenAI

Save Operations Cost using Gen AI

Migrate from Legacy Edifecs

All EDI transactions integrated with FHIR

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What is EDIVal?

EDIVal is a comprehensive Healthcare EDI platform designed for healthcare insurance companies. It offers robust support for payer EDI transactions across various healthcare plans, including Medicare, Medicaid, MediCal, State Plans, Marketplace, and large group commercial plans.

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Enable Gen AI for your Healthcare EDI

Enable GenAI and AI models for your existing EDI. Modernize your EDI to use the power of AI. Gen AI can help you answer operational questions, triage issues and data errors, colloboarate with your IT. Use Predictive AI models to identify data errors, EDI edit and catch errors and fraud before transactions reach your core applications. 

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What you get !

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Input Data Connectors

Connect and Convert Any Data. 50+ Connectors from API, SFTP, MLLP, XML, SOAP, EHRs, Epic, Salesforce and more.

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EDI API Server

Enables seamless healthcare data exchange and interoperability.

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EDI Data Mapping

No Code FHIR Data Converter with AI.

Pre-built data mappings for conversions.

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EDI Data Validation

Automated data validation, mapping, and transformation processes.

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EDI Data Repository

Store, manage, and facilitate access to healthcare data in compliance with the FHIR standard.

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EDI Data Security

Uses latest Oauth 2.0 authentication and follows the HIPAA compliance.

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One Solution, Infinite Possibilities!

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Everything you need to manage claims

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  • 837 I, P, D Inbound and outbound

  • 277CA, 999, TA

  • Claims Validations L1-L7

  • Claims Edits

  • Claims ICD Codes 

  • Claims Status

  • Claims Payments Reconcile

  • Integrated with QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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CORE Eligibility

Everything you need to manage real time and batch eligibility​

  • 270/271 CORE transaction

  • Integrated with CMS

  • Core Rules

  • Eligibility API

  • Utilization

  • Integrated with QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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Everything you need to generate claims payments​

  • 835

  • Reconcile with 837 claims data

  • Compare line items payments

  • Match Lockbox files

  • Match with Invoices

  • Integrate with GL

  • Integrated with QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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Everything you need to manage memberships, enrollments, benefits, eligibility

  • 834 Inbound and outbound

  • Custom 834

  • Flat file to 834

  • Enrollment reconcile 

  • Member check, PCP check

  • Medicare, Medicaid

  • Dual Plan Rate Codes

  • Audit file reconcile

  • Full File reconcile

  • Integrated with QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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CORE Claims Status

Everything you need to manage real time and batch claims status​

  • 276/277 CORE transaction

  • Integrated with CMS

  • Core Rules

  • Claims Status API

  • Integrated with QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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Everything you need to manage 820 FFS Payments​

  • Generate or Load 820

  • Reconcile with membership

  • Manage Invoice Payments

  • Integrate to GL

  • Integrated with QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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Prior Authorization

Everything you need to manage prior authorization

  • 278 Prior Auth real time and batch

  • Manage prior auth queue

  • Approve and Deny Prior auth

  • Manage Attachments 

  • Manage Case notes

  • AI driven confidence code

  • Check eligibility

  • Integrated with Pega, QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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Everything you need to manage attachments ​

  • 275

  • Case Notes and attachments

  • Attach to Claims or Prior Auth

  • Integrated with QNXT, Facets, HealthRules

  • Integrated with CMS FHIR

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Experience the Benefits of Smarter
Healthcare Data
with EDIVal

Reduced administrative costs

Reduced administrative costs

Reduced administrative costs

Reduced administrative costs

EDIVal has built in support for Payers EDI transactions for Medicare, Medicaid, MediCal, State Plans, MarketPlace and Large group commercial plans. Replace or Upgrade your existing expensive or custom EDI platform to EdiVal.

We support all EDI Transactions - Claims, Enrollments, Prior Authorization, Eligibility, Payments, Attachments, Claims status. 

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Modernize your EDI to next generation AI auto data validation and data corrections. Manage various work queues with GenAI integration. Support multiple line of business or multiple states using our business rules templates and no code configuration 

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HiPaaS EDIVal Tool helps you to integrate, map and convert healthcare data faster. It has pre-built templates and validations. 

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Healthcare EDI platform with Gen AI

HiPaaS EDI GenAI integrates with your existing EDI Platform - Custom or Edifecs

Ask simple questions:

  • How many files loaded ?

  • How many members?

  • How many claims?

  • What are errors? and more.

Less Analysis Needed

Triage with simple questions:

  • What are top errors?

  • Triage error based on knowledge base

  • Ask questions about data issues?

  • Request to automatically create ticket

Insights in Data

Ask simple questions

  • How many adds, cancels, changes?

  • Give me data about member?

  • What is plan coverage ?

Case Studies

Contact Us

Leading Enabler of Healthcare Data

HiPaaS Customers

Contact

USA:

6200 Stoneridge Mall Rd, Suite 300

Pleasanton, CA 94588

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5890 Stoneridge Drv #107, 

Pleasanton, CA 94566

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India:

HiPaaS Infotech

Unit-1015, 10th Floor, Lodha Supremus

Kolshet Road, Thane(West)-400607

Philippines:​

GF, Gloria Building, Aguirre, Legazpi Village, Makati, Metro Manila, Philippines

Tel: +1 408-372-4313

Sales:

Email: sales@hipaas.com

Work:

Email: resume@hipaas.com

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© 2025 by HiPaaS. HiPaaS is a Trademark of HiPaaS Inc.

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