X12 Announces Claims Attachment Schema Pilot

The X12 Board is pleased to announce support for a proof-of-concept pilot that utilizes standardized, simplified schema for clinical information request and response messages based on X12's claims attachment metadata. The schema produced under this pilot is based on, and complimentary to, transactions published as part of X12's EDI Standard.


X12 is working closely on this pilot with the Innovations Messaging Group, an industry group that serves as a forum to facilitate discussions and actions on interoperability challenges and ideas that increase the number of trading partners or the number of exchanged transactions using standardized messages in the health care industry.

The pilot's objective calls for X12 to develop standardized, simplified schema which corresponds to their version 6020 277 and 275 transaction sets. The resulting requests and responses can be exchanged in multiple communication modes - over clearing house connections, through secure SMTP (Direct), secure FTP and through restful interfaces (FHIR). X12 member organizations who also participate in the Innovations Messaging Group have volunteered to implement the pilot transactions as part of this end-to-end proof-of-concept and the results of these implementations will be carefully analyzed to determine the viability of the concept.

"X12 continues to partner with its members and other industry representatives to explore and investigate new and expanded opportunities for effective and efficient electronic interchanges that are complementary to existing X12 transaction sets. We are listening to our implementation base and our member representatives and responding in a manner which speeds products to market and creates new pilots such as this one. This provides the ability to prove out ideas on a smaller scale. Once the idea is proven and well-tested, X12 can make them available on a wide-spread basis. Interoperability, simplicity, and clarity of messaging are key goals and we look forward to offering many options and opportunities for implementers as we move forward." said Jim Taylor, X12 Board Chair.

"Multiple work flows for prior authorizations and other reporting are rampant today due to a lack of a scalable interoperable method for exchange of combined administrative and clinical data," said Dan Kazzaz, X12 board member and CEO, Secure Exchange Solutions. "Resolving workflows complexity for providers and payers is a critical next step to reduce costs and friction between payers and providers."

If you have questions or other feedback, please complete and submit the online form at: