Beyond parsing X12: Closing the gap for revenue cycle workflows in healthcare

Genpact and Databricks built an operational workbench to bridge the gap between X12 EDI parsing and actual healthcare revenue cycle workflows.

• •Extended the open-source x12-edi-parser with contextual enrollment tracking and decoded adjustment codes, contributing improvements back to the community
• •Built a secure React web application on Databricks Unity Catalog with real-time SQL queries, eliminating ETL copies and maintaining PHI compliance
• •Deployed six core operational views including Remittance Drawer, Denials Workbench, and Enrollment view to streamline RCM team workflows
• •Leadership Dashboard and Quality Gates provide real-time monitoring of claims, payment rates, and payer feed health with automatic audit logging
• •Planned integration with Claude models via Databricks Foundation Model APIs to auto-draft appeal letters based on CARC codes and clinical documentation