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Turn X12, HL7, FHIR and CMS files into data your teams can use

Prismaid is a no-code integration platform for health plans and healthcare technology companies. Build data flows, publish APIs and manage CMS-0057-F interoperability from one place, in your own environment.

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What comes in

  • X12, HL7 and FHIR
  • CMS files
  • Databases
  • Files and cloud storage
  • APIs and documents

Prismaid, in your environment

What your teams get

  • Clean database tables
  • REST APIs
  • CMS-0057-F interoperability
  • Your UM and FHIR systems
  • Reconciliation reports

One platform, from source to delivery

Your data comes from

Healthcare formatsEDI X12, HL7 v2.x, FHIR R4, CMS files
DatabasesPostgreSQL, MySQL, SQL Server, Oracle
Files and storageCSV, JSON, XML, Excel, SFTP, Amazon S3, Azure Blob, network shares
APIs and documentsREST APIs, webhooks, AWS Textract, Azure Document Intelligence

Your environment: data center, cloud account or air-gapped network

Prismaid platform

Build

  • Saved connections
  • Schemas and versions
  • AI-assisted mapping, reviewed by your team
  • Visual flow canvas
  • Template library

Run

  • Scheduling and retries
  • Change detection
  • Schema drift checks
  • Promotion from development to production

Publish

  • API Builder
  • Prior Authorization API: PAS, CRD and DTR
  • Plan-Net provider directory API
  • Outbound Payer-to-Payer exchange

Oversee

  • Run history and error logs
  • API metrics and service health
  • CMS-0057-F compliance cockpit
  • Provider Access attribution and opt-outs
  • Partners and endpoints
  • Single sign-on
  • Authenticator MFA
  • Encrypted credentials
  • Tamper-evident audit log
  • External or local AI, your choice

Your teams get

Your databasesClean, structured tables for your teams and reports
Your applicationsREST APIs with keys and usage metrics
Your UM systemBuilt-in adapter, REST adapter or X12 278
Your FHIR platformPrior authorization data for member access
Trading partnersGenerated X12 and HL7 files
Compliance teamsReconciliation and public prior authorization metrics

January 1, 2027 is the CMS-0057-F API date

Impacted payers generally need four FHIR APIs from that date, and exact dates vary by payer type. Prior authorization is the one that reaches furthest into your operations.

Prismaid gives health plans a payer-hosted Prior Authorization API built on the Da Vinci PAS, CRD and DTR guides, with a bridge to X12 278 and adapters for your utilization management system.

A compliance cockpit tracks readiness across the rule, including decision clocks, denial reasons, public metrics, partners and endpoints.

See what Prismaid covers

Build integrations without writing integration code

Analysts and engineers work in the same visual tool, on the same flows.

  • Visual data flows

    Drag sources, transformations and destinations onto a canvas, then run them on demand or on a schedule.

  • AI-assisted schema mapping

    Get suggested field mappings between formats, then review and approve them before anything runs.

  • APIs from your connections

    Publish REST APIs over a database or file connection, with API keys, usage metrics and documentation.

  • Healthcare templates

    Start from pre-built healthcare data packages instead of a blank canvas.

One message in, every field separated

A prism separates light into its colors. Prismaid separates a healthcare message into the fields your teams need.

Enrollment file, X12 834

INS*Y*18*021*28*A***FT~
REF*0F*100000001~
NM1*IL*1*DOE*JANE~
DMG*D8*19800101*F~
HD*021**HLT*GOLD PLAN~
DTP*348*D8*20270101~

Enrollment record

Member
Jane Doe
Subscriber ID
100000001
Change
New enrollment
Plan
Gold Plan
Coverage starts
Jan 1, 2027

Admission message, HL7 v2

MSH|^~\&|HIS|GENERAL|PLAN|PAYER|202701011200||ADT^A01|MSG0001|P|2.5
EVN|A01|202701011200
PID|1||MRN1001^^^GENERAL||DOE^JANE||19800101|F
PV1|1|I|4W^401^A

Admission record

Patient
Jane Doe
Record number
MRN1001
Event
Inpatient admission
Location
Unit 4W, room 401, bed A
Admitted
Jan 1, 2027, 12:00 PM

Prior authorization request, FHIR R4

{ "resourceType": "Claim",
  "use": "preauthorization",
  "status": "active",
  "patient": { "reference": "Patient/1001" },
  "item": [{ "sequence": 1,
    "productOrService": { "coding": [{ "code": "E0601" }] } }] }

Prior authorization request

Patient
Patient/1001
Request type
Prior authorization
Service
E0601, CPAP device
Status
Active

Sample data, shortened for display.

Built around the formats healthcare runs on

Not a general integration tool with healthcare added later.

Explore the standards

  • EDI X12

    Enrollment, claims, remittance, eligibility, claim status, prior authorization and acknowledgments.

    • 834
    • 837P
    • 837I
    • 837D
    • 835
    • 270/271
    • 276/277
    • 278
    • 820

  • HL7 v2.x

    Clinical and administrative messages, with an MLLP listener in beta.

    • ADT
    • ORM
    • ORU
    • DFT
    • SIU
    • VXU

  • FHIR R4

    Da Vinci PAS, CRD and DTR for prior authorization, and Plan-Net for provider directories.

  • CMS Medicare files

    Ingest monthly CMS files and reconcile membership and enrollment data across them.

    • MMR
    • MODD
    • DTRR
    • LEPD
    • MSP
    • MCMD

Made for two kinds of team

  • Health plans

    Connect enrollment, claims and CMS data to the systems you already run, and manage interoperability requirements from the same platform.

    Prismaid for health plans

  • Healthcare product and service companies

    Handle customer data feeds and healthcare formats on one platform, so your engineers can get back to your own product.

    Prismaid for health tech

Runs in your environment, under your controls

Prismaid ships as signed container images that you deploy in your own data center or cloud account, with an air-gapped option. Your data is stored on infrastructure you control.

Read about security and deployment

See it working on your kind of data

Book a live demo, or tell us what you need to connect.

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