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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

NameRequiredDescriptionDefault
contentNoRaw 834 text, if the file is not on disk. Avoid pasting production data.
profileNoCarrier companion-guide rules. See README "Carrier profiles".
platformNoSource system. "workday_ccb_834_v2" adds where_to_fix (Workday task or setting) to every finding.
show_piiNoInclude member names in messages. Default false.
file_pathNoPath of the 834 file relative to EDI_834_DIR (preferred: the data never enters the conversation).
max_findingsNoLimit findings returned (errors first). Default 200.
profile_pathNoJSON profile file relative to EDI_834_DIR, e.g. "profiles/acme-health.json".

Schema Changelog

Changes observed during successful MCP inspections.

  1. First observedv0.2.0

TDQS

A4.1/5.0
Behavior4/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations, the description carries the full burden and does well: it discloses the finding shape (rule ID, severity, segment position, message, fix), that PII is redacted by default unless show_pii=true, and that the platform parameter adds where_to_fix metadata. It doesn't state what happens to a malformed or non-834 input, and max_findings truncation behavior is only in the schema.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness4/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Front-loaded with the purpose, then the check categories, then the output shape and the two behavioral modifiers. Dense but every sentence carries information; the long parenthetical check lists are slightly list-like but justified for a validator whose coverage matters.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

There is no output schema, so the description must explain return values, and it does concretely (rule ID, severity, segment position, message, fix, plus where_to_fix for Workday). For a seven-parameter tool some gaps remain — behavior on unparseable input and how max_findings interacts with severity ordering — but the agent has what it needs to call it correctly.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100%, so every parameter already has documentation and the baseline is 3. The description adds only marginal meaning beyond the schema — that a profile may be inline or a profile_path, and what platform=workday_ccb_834_v2 changes in the output — without clarifying profile precedence when both are supplied or relative-path expectations.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

States a specific verb and resource ('Validate a HIPAA X12 005010X220A1 (834) benefit enrollment file') and immediately scopes it ('before it goes to a carrier'). The enumeration of what is checked (envelope, header, members, coverage) makes the tool's remit unmistakable and clearly distinct from summarize_834, compare_834 and explain_834_code, which do different things to the same file.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Gives a real precondition ('before it goes to a carrier') and conditions that change behavior: pass a carrier profile for companion-guide rules, set platform="workday_ccb_834_v2" for Workday-sourced files. It does not explicitly say when to prefer a sibling (summarize_834, compare_834), but the pre-submission validation framing is unambiguous.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.