What Is EDIVAL?
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Healthcare EDI platform for insurance companies
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Supports real-time & batch transactions (270/271, 276/277,837, 835, 834, 820, 278, 999, TA1, 277CA)
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Compatible with Medicare, Medicaid, State, Marketplace & commercial plans
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Offers SNIP L1–L7 validations, custom rules, audits, and AI corrections
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Integrates with QNXT, HealthEdge, Trizetto & EPIC
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AI-powered edits & operations – request our GenAI demo
One Solution, Infinite Possibilities!
Claims Management
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837 I, P, D Inbound and outbound
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277CA, 999, TA
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Claims Validations L1-L7
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Claims Edits
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Claims ICD Codes
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Claims Status
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270/271 CORE transaction
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Core Rules
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Eligibility API
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Utilization
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Integrated with QNXT, Facets, HealthRules
Membership Management
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834 Inbound and outbound
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Flat file to 834
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Enrollment reconcile
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Member check, PCP check
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Medicare, Medicaid
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276/277 CORE transaction
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Integrated with CMS
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Core Rules
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Claims Status API
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Integrated with CMS FHIR
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278 Prior Auth real time and batch
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Manage prior auth queue
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Approve and Deny Prior auth
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Manage Attachments
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837 I, P, D Inbound and outbound
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277CA, 999, TA
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Claims Validations L1-L7
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Claims Edits
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Claims ICD Codes
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Claims Status
Enable AI agents for any use case
Enrollment Operations with Agentic AI
Enhancing EDI 834 Exception Handling with HiPaaS Intelligence (GenAI).
Hire our AI Agent to manage Prior Authorization
The prior authorization process can often be a time-consuming and challenging task for healthcare
Built on a Modern, Enterprise-Grade Stack
EDIVal leverages best-in-class technology to support real-time, high-volume EDI processing. With Boomi powering rapid integration into platforms like Facets, HealthEdge, and Availity, and Neo4j enabling advanced graph-based validation for member, provider, and claims data, EDIVal delivers performance, scalability, and flexibility modern payers require.
What You Get!
EDI SNIP Validation
SNIP Level Validation L1-L7 and Custom Edits, L8-L9Rules Engine AI Smart Corrections
EDI Data Mapping
EDI solutions with API support and pre-built JSON mappings for QNXT, HealthEdge, TriZetto, and Epic.
EDI Data Repository
Store, manage, and access healthcare data with compliance using Nodes, Graph, and enabling easy retrieval of any data element or relationship.
Input Data Connectors
Connect and Convert Any Data. 50+ Connectors from API, SFTP, MLLP, XML, SOAP, EHRs, Epic, Salesforce and more.
EDI API Server
Enables seamless healthcare data exchange and interoperability.
EDI Data Security
Uses latest Oauth 2.0 authentication and follows the HIPAA compliance.
Healthcare EDI platform with Gen AI
HiPaaS EDI GenAI integrates with your existing EDI Platform - Custom or Edifecs
Simple Operations
Ask simple questions
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How many files loaded ?
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How many members?
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How many claims?
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What are errors? and more..
Less Analysis Needed
Triage with simple questions
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What are top errors?
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Triage error based on knowledge base
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Ask questions about data issues?
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Request to automatically create ticket
Insights in
Data
Ask simple questions
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How many adds, cancels, changes?
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Give me data about member?
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What is plan coverage ?
Case Studies
Ready to Help Your Company to Scale Faster?
Let's chat about how we can help.
Call us
Email us
Tel: +1 408-372-4313