Claims Data Pipeline
From X12 Claims Files to FHIR Resources and Revenue Cycle Analytics
Overview
CodeBricks built a claims data pipeline implementation that processes synthetic X12 claim and remittance files, maps them to FHIR Claim and ClaimResponse resources, and turns the output into revenue cycle analytics. The project demonstrates practical knowledge of healthcare data engineering, EDI parsing, transformation testing, and reporting for billing operations.
The Challenge
X12 EDI is difficult for general engineering teams because it is rigid, compact, and domain-specific. A small parsing mistake can change the meaning of a claim or remittance. RCM buyers also expect familiar operational metrics. A dashboard with generic counts is not enough. Analytics need to reflect real questions: denial rate, days in accounts receivable, payer mix, aging buckets, and denial reason patterns.
Research & Strategy
We organized the pipeline in clear stages: ingest, parse, transform, load, and report. Synthetic X12 837 and 835 files enter an ingestion step validated for file type and run metadata. A real X12 parser library converts EDI segments into structured records. The transformation layer maps those records into FHIR R4 Claim and ClaimResponse resources before loading DuckDB or Postgres warehouse tables. SQL models calculate RCM metrics that feed a dashboard built for billing operations review, not generic tutorial charts.
The Solution
Results & Impact
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