EDI Testing Files for HIPAA Compliance – Free Download

The best option when EDI testing is to utilize a tool to generate files that meet compliance with HIPAA security regulations. Using sample X12 EDI files for system testing is standard practice for developers and avoids the risk and liability of compromising patient data.  The testing process ensure the ability to transmit files, accept and process response files, and correctly submit adds, changes, and deletes. An overview of typical system testing can be found in the CMS testing process overview. The following guide below demonstrates a simple method to generating EDI sample files to be used in HIPAA compliant system testing. 

How to Generate HIPAA Compliant EDI Test Files

In the example below we demonstrate generating sample files for system testingFollow these 4 Easy steps to generate a EDI 834 Enrollment test file

1. Step 1 : Download the HIPAA EDI Testing File Generator, X12 Studio Toolbox

First, get the free download of X12 Studio Toolbox (download triggered by bottom form submission). From there the process for utilizing this feature is pretty straightforward.

To start, click on the “HIPAA EDI File Generator” button located in the top menu:

HIPAA Test File Generator - X12 Studio Toolbox

Step 2: Choose a HIPAA Transaction Set Type

From there you will be prompted to configure the EDI file type you wish to generate as well as the complexity of the EDI test file to be generated. To start, click on “Choose A Type” to view the drop down menu:


Healthcare Transaction Type Selection

The HIPAA EDI File Generator supports the creation of  an EDI file based on all available 5010 HIPAA transaction types. For this sample, you can select “X834” for  the 834 Benefit Enrollment file type:

HIPAA compliant 834 file format selection

Step 3: Choose EDI File Complexity

Next, you have the option to select between “Minimal” and “Complete” file complexity, this will determine whether we generate a basic EDI file with only the minimum fields required by X12 EDI specifications, or a EDI test file that has almost every field populated with sample data, respectively.

For this example, select “Minimal” to generate a small, simple EDI 834 sample file:

EDI file complexity setting

Step 4: Generate your EDI File

Now click “Generate” and the EDI test file will be created:

Generate HIPAA compliant x12 file button

In the console window at the bottom of the X12 Studio Toolbox tool, you can see our generated X12 file, and from there open the EDI file up and view the HIPAA compliant data:

Open EDI files

ISA*00* *00* *ZZ*SampleTP1 *ZZ*CALIBER *171102*1209*^*00501*000000006*0*P*:~ GS*BE*SampleTP1*CALIBER*20171102*1209*1*X*005010X220A1~ ST*834*0001*005010X220A1~ BGN*15*PDL5N7H3*20171102*1209****RX~ N1*P5*3OVESY5C*24*63DDQSEN~ N1*IN*4HI740FI*XV*TTA3X1JN~ INS*Y*15*025**C~ REF*0F*SVAIO434~ NM1*IL*1*Q1NMQ9S1~ INS*Y*25*030**S~ REF*0F*PJZ73B0Z~ NM1*74*1*6LQDIMMP~ SE*11*0001~ GE*1*1~ IEA*1*000000006~

In conclusion, in just a few steps you can generate valid, simple or complex EDI files for HIPAA compliant system testing purposes. Once you have used the EDI file generator to create healthcare EDI transaction test files, be sure to leverage some of the other components that X12 Studio Toolbox has to offer .

EDI Testing and File Validation Developer Toolkit

Caliber Health’s  X12 Studio Toolbox provides a set of x12 developer tools helpful for streamlining HIPAA processes, including HIPAA File Generation. This X12 developer toolkit can generate EDI testing files from any of the HIPAA transaction types at the click of a button, helping to streamline the system performance test needs of X12 developers.

Healthcare EDI transaction viewer

X12 Studio Toolbox loads EDI transactions into a hierarchical tree view. With search features and expandable nodes, it’s easy to navigate and understand the structure of your EDI documents.

Thanks for reading our blog on generating EDI testing files. Be sure to checkout our T-Connect EDI Database Plus SDK for developers with callable EDI APIs to streamline your healthcare X12 development needs. 

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