validate_834
Validates HIPAA X12 834 benefit enrollment files before carrier submission by checking envelope, member, and coverage data and returning rule-based findings with fixes.
Instructions
Validate a HIPAA X12 005010X220A1 (834) benefit enrollment file before it goes to a carrier. Checks the envelope (ISA/GS/ST counts and control numbers), header (BGN, sponsor, payer), every member (relationship, maintenance codes, subscriber ID, SSN structure, birth date, age limits) and every coverage (insurance line, coverage tier, begin/end dates, retro and future dates, terminations without end dates, employee-only tiers with dependents enrolled). Each finding has a rule ID, severity, segment position, plain-English message and fix. Names, SSNs and birth dates are never included unless show_pii=true. Pass a carrier profile (inline or profile_path) to apply companion-guide rules. Set platform="workday_ccb_834_v2" for files from Workday Cloud Connect for Benefits 834 V2: each finding then says where in Workday to fix it (map, attribute, service, security or data).
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| content | No | Raw 834 text, if the file is not on disk. Avoid pasting production data. | |
| profile | No | Carrier companion-guide rules. See README "Carrier profiles". | |
| platform | No | Source system. "workday_ccb_834_v2" adds where_to_fix (Workday task or setting) to every finding. | |
| show_pii | No | Include member names in messages. Default false. | |
| file_path | No | Path of the 834 file relative to EDI_834_DIR (preferred: the data never enters the conversation). | |
| max_findings | No | Limit findings returned (errors first). Default 200. | |
| profile_path | No | JSON profile file relative to EDI_834_DIR, e.g. "profiles/acme-health.json". |