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009-x12-first-class.md

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ADR 009: X12 Remains First-Class Beside FHIR

Status

Accepted

Context

FHIR is essential for modern interoperability, but payer operations still depend heavily on X12 transactions: 837 claims, 834 enrollment, 270/271 eligibility, 276/277 claim status, 278 authorization, 835 remittance, and attachments.

Decision

Keep X12 first-class beside FHIR. Do not treat X12 as a temporary import format or hide it behind FHIR-only abstractions.

Consequences

Positive:

  • Clearinghouse and trading-partner workflows remain explicit.
  • Claims, enrollment, remittance, and authorization workflows can preserve EDI control numbers and acknowledgements.
  • FHIR and X12 can be reconciled through domain models and projections.

Tradeoffs:

  • The platform must maintain both FHIR and X12 expertise.
  • Documentation must identify which workflows are FHIR-facing, X12-facing, or both.

References