X12 EDI Claims Pipeline — 270/271/837P/835 transactions with revenue cycle analytics
End-to-end X12 EDI transaction pipeline covering the complete US healthcare revenue cycle — from eligibility verification through claim submission and payment reconciliation.
| Transaction | Purpose | Direction |
|---|---|---|
| X12 270 | Eligibility Inquiry | Provider → Payer |
| X12 271 | Eligibility Response | Payer → Provider |
| X12 837P | Professional Claim | Provider → Payer |
| X12 835 | Remittance Advice (ERA) | Payer → Provider |
ISA · IEA · GS · GE · ST · SE · BPR · TRN · NM1 · CLM CLP · SV1 · SVC · DTP · HI · CAS · EB · EQ · DTM
- Billed vs paid analysis by payer
- Collection rate benchmarking
- Claim denial patterns (CARC codes)
- CPT category distribution
- Eligibility verification workflow
Synthea FHIR R4 synthetic patients — no PHI, fully HIPAA-safe
Python · pandas · numpy · matplotlib · json
Nipa Shah — Data Scientist | Healthcare Analytics | AI/ML
📍 Jersey City, NJ
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