Proof, not promises.
After running into several complex, unsolved problems in EDI claim processing, we set out to crack them ourselves — building a complete EDI claims-processing suite as a proof of concept, engineered to government-security grade, from raw ingest to a cryptographically provable audit trail. It parses, validates, and projects a 517 KB file of 3,200 claims in 0.0475 seconds. Here's what that involved.
Government-grade EDI/X12 validation
A multi-level validation engine spanning integrity, requirement, balancing, situational, code-set, and implementation-guide checks — built on a loop-aware parser that produces a positioned segment tree, and emitting standards-conformant machine acknowledgments. Every issue is anchored to its exact segment, element, and loop so it can be surfaced precisely.
National correct-coding & coverage scrubbing
Automated NCCI (PTP/MUE) unbundling, NCD/LCD coverage logic, modifier-to-procedure relationships, sequencing, eligibility, and duplicate detection — all driven by versioned rule tables so the engine tracks regulatory updates rather than hard-coding them.
Bidirectional FHIR R4 interoperability
Full FHIR R4 mapping across CARIN and Da Vinci profiles, translating legacy transaction formats to and from modern FHIR resources — the bridge between decades-old standards and a modern, API-first ecosystem.
Tier 0–3 AI routing with supervised swarms
A deterministic fast-path handles conforming work with zero AI cost; harder cases escalate through scored, gated tiers to parallel specialist agents working under a supervisor policy. Every routing decision carries a confidence score and its trigger reasons, and is recorded for replay — measurable efficiency, not magic.
Tamper-evident provenance ★
Deterministic record identity plus an append-only journal with Merkle-proof verification and full lineage projection — a cryptographically provable, audit-ready history of every record and transformation. When "trust us" isn't good enough, the math is.
Operator-grade by default.
Gated pipelines
Real CI/CD with secret scanning, dependency CVE remediation, and branch protection — green means green.
Self-hostable
Runs on your infrastructure. Your data stays yours — no mandatory third-party cloud.
Provable
Audit surfaces, signed components, and reporting built in — so compliance is the starting state, not the cleanup phase.