FHIR to X12: PilotFish to Demo at X12 Fall Meeting in Greenville, SC

Greenville, SC – October 1, 2025 — PilotFish Technology, a leader in healthcare integration solutions, is pleased to be a sponsor of the upcoming X12 Fall Standing Meeting in Greenville, South Carolina. On Wednesday, October 1, from 4:00 – 5:30 PM, PilotFish will present a live demonstration that tackles one of healthcare’s most pressing challenges: transforming HL7 FHIR prior authorizations to/from X12 278 transactions.

Why It Matters: Readiness to Meet FHIR CMS-0057-F Mandates and Avoid Penalties

Payers and providers are racing to modernize their data exchange workflows to meet the FHIR CMS-0057-F mandates for prior authorizations in 2026 and 2027. The challenge: Most backend systems still rely on X12 EDI and the 278 transaction for service review and authorization. PilotFish’s live demo will show how to bridge this gap – without ripping and replacing legacy infrastructure.

Attendees will see how PilotFish’s graphical interface process translates FHIR resources to X12 278 prior authorization requests and responses and vice versa, meeting the technical expectations of CMS-0057-F.

FHIR to X12 278 Prior Auth Workflow using PilotFish

Demo Highlights

PilotFish’s integration platform delivers a seamless transformation pipeline:

• FHIR Intake: A FHIR-based prior authorization request can be received via RESTful API.
• Data Mapping: Using PilotFish’s visual drag & drop Data Mapper, the FHIR JSON payload is converted to XML and mapped to the X12 278 format.
• Validation: The resulting X12 message is validated against SNIP Types 1–7 to ensure compliance and data integrity.
• Routing: The transaction can be securely transmitted to a simulated payer endpoint via SFTP.

Prior authorizations workflows are automated and audited end-to-end with PilotFish’s built-in support for both FHIR and X12 standards.

Real-world operational pain points addressed:

• Reducing delays in care by streamlining prior authorization submissions
• Improving transparency with built-in decision timeframe tracking
• Enabling CMS compliance with support for Patient Access and Provider Access APIs

PilotFish: Built for the Future, Delivering Interoperability Today

PilotFish is already helping payers prepare for the CMS deadlines, offering a future-proof path to interoperability that doesn’t compromise on legacy compatibility. As the healthcare industry transitions to FHIR-first architectures, PilotFish remains at the forefront with flexible, standards-based integration tools.

PilotFish invites all attendees to visit its live demonstration on October 1 (4:00-5:30) and see how interoperability isn’t just possible — it’s practical.

For more information about PilotFish’s EDI solutions, visit X12 EDI Integration.

About PilotFish: PilotFish, Inc. is a leader in integration and interoperability solutions. It provides tools and expertise to simplify the challenges of data transformation and exchange. With proven solutions tailored to the needs of healthcare, insurance and other industries, PilotFish enables organizations to achieve faster implementation times, greater efficiency and lower costs.

X12, chartered by the American National Standards Institute for more than 35 years, develops and maintains EDI standards and XML schemas.