Cloud Health Office

Turn weeks of payer EDI onboarding into minutes. X12 270/271/837/278 ↔ FHIR R4 Multi-cloud (Azure/AKS/EKS/GKE) + Argo + Kafka CMS-0057-F ready • HIPAA hardened

---

Why Cloud Health Office?

### ⚡ 95% Faster Weeks → Minutes for payer onboarding Traditional: 6-8 weeks Cloud Health Office: 5 minutes	### ☁️ True Multi-Cloud Azure, AWS, GCP - No lock-in Deploy once, run anywhere AKS • EKS • GKE	### 🔒 HIPAA Ready Production-grade security built-in CMS-0057-F compliant Jan 2027 deadline

🎯 Perfect For

• 🏥 Payers needing CMS-0057-F compliance by Jan 2027
• 🏢 Clearinghouses wanting multi-cloud flexibility
• 💼 Healthcare SaaS building EDI capabilities
• 🚀 Startups launching payer platforms fast

---

🚀 Try It Now - Interactive Demo

Choose your path:

🎯 I want the fastest deploy (5 min) → Azure

# Clone and deploy
git clone https://github.com/aurelianware/cloudhealthoffice.git
cd cloudhealthoffice
npm install && npm run build

# Interactive wizard
npm run generate -- interactive --output my-config.json --generate

# Deploy to Azure
az deployment group create \
--resource-group my-rg \
--template-file infrastructure/azure/main.json

What you get:

• ✅ Complete EDI processing platform
• ✅ FHIR R4 APIs (X12 ↔ FHIR transformation)
• ✅ HIPAA-compliant infrastructure
• ✅ 424 passing tests

📖 Full Azure deployment guide

☸️ I want multi-cloud flexibility → Kubernetes

# Add Helm repos
helm repo add argo https://argoproj.github.io/argo-helm
helm repo add bitnami https://charts.bitnami.com/bitnami
helm repo update

# Deploy to any Kubernetes cluster (AKS/EKS/GKE)
helm install cloudhealthoffice ./helm/cloudhealthoffice \
--namespace cloudhealthoffice \
--create-namespace

Supports:

• ✅ Azure Kubernetes Service (AKS)
• ✅ Amazon Elastic Kubernetes Service (EKS)
• ✅ Google Kubernetes Engine (GKE)
• ✅ Any CNCF-compliant Kubernetes

📖 Multi-cloud deployment guide

🧪 I just want to test it → Try the examples

# Clone the repo
git clone https://github.com/aurelianware/cloudhealthoffice.git
cd cloudhealthoffice && npm install && npm run build

# Run FHIR compliance tests
npm run test:fhir

# Generate synthetic test data
node dist/scripts/utils/generate-837-claims.js 837P 10 ./test-data

# Explore example configurations
ls core/examples/
# → medicaid-mco-config.json
# → regional-blues-config.json

Test without deploying:

• ✅ 424 automated tests
• ✅ Synthetic test data generator
• ✅ Example payer configurations
• ✅ FHIR validation tools

📖 Testing guide

---

An open-source, multi-cloud platform for multi-payer EDI integration in healthcare. Deploy to Azure Logic Apps (fastest) or Kubernetes (AKS, EKS, GKE) for cloud independence.

📢 v3.0.0 — The Open Frontier Release: Multi-cloud independence with Kubernetes/Argo Workflows, Azure Marketplace ready, AI-powered ClaimRiskScorer, and commercial launch materials. See Release Notes

🚀 What’s New in v3.0.0

Cloud Health Office v3.0.0 delivers multi-cloud independence, enabling deployment on Azure, AWS, GCP, or any Kubernetes cluster—while maintaining HIPAA compliance and production-grade security.

v3.0.0 Highlights

Capability	Description	Status
🌐 Multi-Cloud Deployment	Deploy on Azure, AWS (EKS), GCP (GKE), or any Kubernetes cluster	✅ Complete
🔄 Argo Workflows	Cloud-native EDI processing replacing Azure Logic Apps	✅ Complete
📨 Apache Kafka	Cloud-agnostic messaging system replacing Azure Service Bus	✅ Complete
🔐 HashiCorp Vault	Open-source secrets management alternative	✅ Complete
🤖 ClaimRiskScorer	ML-powered fraud detection with PyTorch (0-100 scoring)	✅ Complete
🛒 Azure Marketplace	Managed application with meter-based billing	✅ Ready
💼 Commercial Materials	Sales collateral, ROI calculator, pitch deck	✅ Complete
📊 Eligibility Service	Dual X12 270/271 + FHIR interface microservice	✅ Complete

Cloud Independence Dashboard

┌──────────────────────────────────────────────────────────────────┐
│               Multi-Cloud Deployment Status                      │
├──────────────────────────────────────────────────────────────────┤
│  Azure Logic Apps .................... ✅ SUPPORTED             │
│  Azure Kubernetes (AKS) .............. ✅ SUPPORTED             │
│  AWS Elastic Kubernetes (EKS) ........ ✅ SUPPORTED             │
│  Google Kubernetes Engine (GKE) ...... ✅ SUPPORTED             │
│  HashiCorp Vault ..................... ✅ INTEGRATED            │
│  Apache Kafka ........................ ✅ INTEGRATED            │
│  Argo Workflows ...................... ✅ INTEGRATED            │
├──────────────────────────────────────────────────────────────────┤
│  Cloud Providers Supported: 3 (Azure, AWS, GCP)                  │
│  Total Tests Passing: 424                                        │
└──────────────────────────────────────────────────────────────────┘

v3.0.0 Microservices

Service	Interface	Features
Eligibility Service	X12 270/271 + FHIR	Cosmos DB caching, Event Grid publishing
Patient Access API	FHIR R4	OAuth 2.0, CMS-0057-F compliant, Da Vinci PDex
ClaimRiskScorer	Service Bus trigger	PyTorch model, custom ZZZ segment
Provider Directory API	FHIR	NPPES NPI real-time lookup
Prior Auth API	Da Vinci PAS	72-hour SLA automated tracking

Quick Links

• 📋 v3.0.0 Release Notes - Detailed release information
• 🌐 Multi-Cloud Deployment - Kubernetes deployment guide
• 🔄 Argo Migration Guide - Logic Apps to Argo migration
• 📖 CMS-0057-F Compliance Guide - Implementation checklist
• 🔗 FHIR Integration Guide - Technical documentation
• 🧪 Sandbox Testing - Try before you deploy

Early Adopter Program

Join our early adopter program for priority support and implementation guidance:

# Deploy sandbox environment
npm run generate -- interactive --output my-config.json --generate

# Run FHIR compliance validation
npm run test:fhir

Contact: early-adopters@aurelianware.com

---

🚀 Quick Start

Deploy a complete HIPAA-compliant EDI platform in <5 minutes:

Option A: Azure Logic Apps (Recommended for Azure-first)

Automated Deployment with GitHub Actions ⭐ NEW

The simplest way to deploy - fully automated with secure defaults:

1. Fork this repository to your GitHub account
2. Configure GitHub Secrets (minimum required):

• AZURE_CLIENT_ID - Application (Client) ID
• AZURE_TENANT_ID - Azure AD Tenant ID
• AZURE_SUBSCRIPTION_ID - Azure Subscription ID

1. Push to main branch - Deployment automatically starts
2. Approve deployment - Review and approve in GitHub Actions

See Production Deployment Guide for complete instructions.

Features:

• ✅ Automated app registration and service principal creation
• ✅ Three-tier secret fallback (Key Vault → GitHub Secrets → defaults)
• ✅ Static Web App with multi-tenant Azure AD authentication
• ✅ Automatic retry logic and health checks
• ✅ Single production environment (no DEV/UAT complexity)

Manual Deploy to Azure (Alternative)

1. Click Deploy to Azure ☝️ (button above)
2. Configure basic settings (baseName, region)
3. Deploy workflows via CLI
4. Start processing 270/275/277/278/837 transactions

Option B: Kubernetes (Multi-Cloud)

Deploy to AKS, EKS, or GKE for cloud independence:

# Add Helm repos and deploy
helm repo add argo https://argoproj.github.io/argo-helm
helm install cloudhealthoffice ./helm/cloudhealthoffice --namespace cloudhealthoffice

See Multi-Cloud Deployment Guide for complete instructions.

Choose Your Architecture

Architecture	Deploy Time	Best For
Azure Logic Apps	<5 min	Rapid deployment, Azure-only
Kubernetes	15-30 min	Multi-cloud, existing K8s

See QUICKSTART.md for detailed guide.

✨ What’s New

Enhanced Onboarding Experience

• 🎯 Interactive Wizard - Guided configuration typically in under 5 minutes, based on testing
• ⚡ One-Click Azure Deploy - Instant sandbox environment
• ☸️ Kubernetes Support - Deploy to AKS, EKS, or GKE with Helm
• 🔓 HashiCorp Vault Integration - Open-source secrets management for cloud independence
• 🧪 Test Data Generator - Synthetic 837 claims for testing
• 📊 E2E Test Suite - Automated health checks and reporting
• 🔒 PHI Validation - Automated HIPAA compliance checks
• 📚 Comprehensive Docs - Quickstart + 60+ troubleshooting solutions

Try It Now

# Interactive wizard mode
git clone https://github.com/aurelianware/cloudhealthoffice.git
cd cloudhealthoffice && npm install && npm run build
npm run generate -- interactive --output my-config.json --generate

# Or use Azure Deploy button above for instant sandbox
# Or deploy to Kubernetes (see docs/MULTI-CLOUD-DEPLOYMENT.md)

📋 Core Features

EDI Transaction Processing

• ✅ 275 Attachments - Clinical and administrative attachment processing with file validation
• ✅ 277 RFAI - Request for Additional Information outbound workflow
• ✅ 278 Authorizations - Prior authorization requests (inpatient, outpatient, referrals)
• ✅ 278 Authorization Inquiry - Real-time status checks for existing authorizations
• ✅ 278 Replay Endpoint - HTTP endpoint for deterministic transaction replay
• ✅ 837 Claims - Professional, Institutional, and Dental claims submission support
• ✅ 270/271 Eligibility - Real-time eligibility verification with 6 search methods
• ✅ 276/277 Claim Status - Claim status inquiries with date range filtering

Zero-Code Payer Onboarding

• ✅ Config-to-Workflow Generator - TypeScript-based automation for deployment artifacts
• ✅ Interactive Configuration Wizard - Guided setup typically in under 5 minutes, based on testing
• ✅ 30+ Handlebars Template Helpers - Comprehensive template system
• ✅ 23-Test Suite - Validated workflow and infrastructure generation
• ✅ Example Configurations - Medicaid MCO and Regional Blues templates

FHIR R4 Integration (CMS-0057-F Compliant)

• ✅ Complete Transaction Coverage - X12 270/837/278/835 → FHIR R4 mappers
• ✅ X12 837 → FHIR Claim - Professional claims with Da Vinci PDex profiles
• ✅ X12 278 → FHIR ServiceRequest - Prior authorization with Da Vinci PAS/CRD
• ✅ X12 835 → FHIR ExplanationOfBenefit - Remittance with adjudication details
• ✅ CMS-0057-F Compliance Checker - Automated validation of data classes & timelines
• ✅ Azure FHIR Validator - Profile validation via Azure API for FHIR
• ✅ US Core + Da Vinci IGs - PDex, PAS, CRD, DTR profile conformance
• ✅ 45 Comprehensive Tests - 100% pass rate, production-ready
• ✅ Zero External Dependencies - Secure core mappers with no vulnerabilities

Enhanced Claim Status (ECS)

• ✅ ValueAdds277 Premium Features - 60+ enhanced response fields
• ✅ Cross-Module Integration Flags - Seamless appeals, attachments, corrections
• ✅ Premium Product Capability - Potential value-add of up to $10k/year per payer (varies by implementation)
• ✅ Provider Time Savings - May save providers time on claim lookups
• ✅ Configurable Field Groups - Financial, clinical, demographics, remittance

Production-Grade Security

• ✅ Premium Key Vault - HSM-backed keys (FIPS 140-2 Level 2)
• ✅ Private Endpoints - Complete network isolation for PHI
• ✅ PHI Masking - DCR-based redaction in Application Insights
• ✅ Customer-Managed Keys - Optional BYOK for compliance
• ✅ Data Lifecycle Management - 7-year retention, automated tiering
• ✅ HIPAA Compliance - Addresses key HIPAA technical safeguards

Deployment & Operations

• ✅ One-Click Azure Deploy - Instant sandbox environment
• ✅ Gated Release Strategy - Pre-approval security validation for UAT/PROD
• ✅ E2E Test Suite - Automated health checks and reporting
• ✅ Synthetic Test Data - 837 claim generator (no real PHI needed)
• ✅ CI/CD PHI Validation - 18 automated tests prevent PHI exposure
• ✅ Comprehensive Monitoring - Application Insights with PHI-safe logging

🎯 Key Capabilities

Config-to-Workflow Generator

Streamline deployment processes that traditionally take weeks:

# Interactive wizard mode
npm run generate -- interactive --output my-config.json --generate

# Or generate from existing config
node dist/scripts/generate-payer-deployment.js core/examples/medicaid-mco-config.json

What It Generates:

• Complete Logic App workflows (workflow.json files)
• Bicep infrastructure templates
• Deployment scripts and documentation
• JSON validation schemas
• Payer-specific configuration

Documentation: CONFIG-TO-WORKFLOW-GENERATOR.md

FHIR R4 Integration (CMS-0057-F Compliant)

Bridge traditional X12 EDI with modern FHIR APIs:

import {
mapX12270ToFhirEligibility,
mapX12837ToFhirClaim,
mapX12278ToFhirServiceRequest,
mapX12835ToFhirExplanationOfBenefit
} from './src/fhir/fhir-mapper';
import { checkCMSCompliance } from './src/fhir/compliance-checker';

// X12 837 → FHIR Claim
const claim = mapX12837ToFhirClaim(x12_837_data);

// X12 278 → FHIR ServiceRequest (Prior Auth)
const serviceRequest = mapX12278ToFhirServiceRequest(x12_278_data);

// Validate CMS-0057-F compliance
const result = checkCMSCompliance(serviceRequest);
console.log('Compliant:', result.compliant, 'Score:', result.score);

Standards Compliance:

• CMS-0057-F: Prior Authorization Final Rule ✓
• HIPAA X12: 270/837/278/835 (005010 series) ✓
• HL7 FHIR R4: v4.0.1 ✓
• US Core Patient: 3.1.1 ✓
• CMS Patient Access Rule: Ready ✓

Documentation: FHIR-INTEGRATION.md

ValueAdds277 Enhanced Claim Status

Premium ECS features that save providers 7-21 minutes per lookup:

Enhanced Fields:

• Financial (8 fields): BILLED, ALLOWED, PAID, COPAY, COINSURANCE, DEDUCTIBLE
• Clinical (4 fields): Diagnosis codes, procedure codes, service dates
• Demographics (4 objects): Patient, subscriber, billing provider, rendering provider
• Remittance (4 fields): Check/EFT details, payment date, trace numbers

Integration Flags:

• eligibleForAppeal - Direct link to appeals module
• eligibleForAttachment - Send HIPAA 275 attachments
• eligibleForCorrection - Resubmit corrected claims
• eligibleForRemittanceViewer - View 835 remittance data

ROI: Potential value-add of up to $10k/year per payer (varies by implementation)

Documentation: VALUEADDS277-IMPLEMENTATION-COMPLETE.md

Security Hardening

Production-ready security for PHI workloads with high security maturity (self-assessed):

Infrastructure:

• Premium Key Vault with HSM-backed keys
• Private endpoints (Storage, Service Bus, Key Vault)
• VNet integration for Logic Apps
• Customer-managed keys (optional BYOK)

Compliance:

• Addresses key HIPAA technical safeguards ✓
• Automated PHI masking in logs ✓
• 7-year data retention with lifecycle management ✓
• 365-day audit log retention ✓

Cost Impact: Estimated 94% storage cost reduction based on lifecycle policies; actual savings vary

Documentation: SECURITY-HARDENING.md

🤝 Integration Focus

Cloud Health Office is backend-agnostic and designed to integrate seamlessly with existing systems like claims adjudication systems, providing enhancements to EDI workflows without requiring full system replacement.

📖 Documentation

Getting Started

• What’s New - Major updates since v1.0.0 with highlights and metrics
• Quick Start Guide - Deploy in 5 minutes
• Onboarding Guide - Complete setup instructions
• Troubleshooting FAQ - 60+ solutions

Features & Capabilities

• Complete Feature Matrix - Comprehensive feature overview with comparison tables
• Config-to-Workflow Generator - Zero-code payer onboarding
• FHIR R4 Integration - X12 to FHIR transformation
• ValueAdds277 - Enhanced claim status
• ECS Integration - Enhanced Claim Status API

Security & Compliance

• Security Hardening - Production security controls
• HIPAA Compliance Matrix - Regulatory mapping
• Security Guide - General security practices

Deployment & Operations

• Deployment Guide - Step-by-step Azure deployment

• Multi-Cloud Deployment - Kubernetes (AKS/EKS/GKE) deployment

• Gated Release Guide - UAT/PROD approval workflows

• Federated Credentials Setup - GitHub Actions OIDC authentication for Azure deployment

• Secrets Management - GitHub Secrets and Azure Key Vault setup

• Secrets Inventory - Complete categorization of deployment secrets

• Key Vault Migration Guide - Migrate secrets to Azure Key Vault for enhanced security

• Architecture - Technical deep-dive

Cloud Independence

• HashiCorp Vault Integration - Open-source secrets management
• Helm Charts - Kubernetes deployment via Helm
• Argo Workflows - Cloud-native workflow orchestration

🏥 CMS Interoperability & Prior Authorization Compliance

Cloud Health Office provides comprehensive CMS-0057-F compliance for payer systems, enabling full support for federal interoperability mandates with minimal implementation effort.

CMS-0057-F Final Rule Support

Advancing Interoperability and Improving Prior Authorization Processes (March 2023)

✅ Patient Access API - FHIR R4 claims, encounters, and clinical data ✅ Provider Access API - Real-time access to patient health information ✅ Payer-to-Payer API - 5-year historical data exchange on enrollment ✅ Prior Authorization API - 72-hour urgent, 7-day standard response tracking ✅ USCDI v1/v2 - Complete data class coverage via FHIR resources ✅ Da Vinci IGs - PDex, PAS, CRD, DTR implementation guide support

Key Capabilities

// X12 EDI to FHIR R4 transformation
import { mapX12837ToFhirClaim, mapX12278ToFhirPriorAuth } from './src/fhir/fhir-mapper';

// 837 Claims → FHIR Claim
const claim = mapX12837ToFhirClaim(x12_837_data);

// 278 Prior Auth → FHIR ServiceRequest
const authRequest = mapX12278ToFhirPriorAuth(x12_278_data);

// Compliance validation
import { validateCMS0057FCompliance } from './src/fhir/compliance-checker';
const result = validateCMS0057FCompliance(fhirResource);

Deployment: <10 minutes from configuration to live FHIR APIs using the CLI wizard.

Documentation: See CMS-0057-F Compliance Guide for detailed requirements, implementation steps, and payer checklist.

Compliance Deadline: January 1, 2027 (MA, Medicaid, CHIP, QHP issuers)

---

🧪 Testing

# Run all tests (166+ tests including FHIR)
npm test

# Run FHIR-specific tests
npm run test:fhir

# Generate synthetic test claims
node dist/scripts/utils/generate-837-claims.js 837P 10 ./test-data

# End-to-end health checks
./scripts/test-e2e.ps1 -ResourceGroup my-rg -LogicAppName my-la

# Workflow testing
./test-workflows.ps1 -TestFullWorkflow

🛡️ Security & Compliance

All logging automatically redacts PHI:

import { redactPHI } from './src/security/hipaaLogger';
console.log('Patient:', redactPHI(patient)); // Safe

Automated PHI scanning in CI/CD prevents accidental exposure.

CMS-0057-F Interoperability & Patient Access

Cloud Health Office is designed to support CMS-0057-F (CMS Interoperability and Patient Access final rule) compliance:

Regulatory Mandate:

• Patient Access API: FHIR R4 API enabling patients to access their health information
• Provider Access API: FHIR R4 API for providers to access patient data with consent
• Payer-to-Payer API: Data exchange during member transitions between payers
• Prior Authorization API: FHIR-based prior authorization workflow automation

Development Best Practices:

✅ Code Generation (80% automated): Handlebars templates and AI-assisted prompts generate API scaffolding, resource mappers, and test suites to accelerate development while ensuring consistency.

✅ Security Review: All PRs require security validation:

• No hard-coded secrets (Azure Key Vault/environment variables only)
• Mandatory PHI/PII redaction in logs (redactPHI() function)
• Comprehensive audit logging for all data access operations
• CodeQL security scans with zero critical/high findings

✅ Automated Testing/CI: Full test coverage enforced:

• Jest Test Suite: Unit, integration, and compliance tests (90%+ coverage)
• API Coverage: Patient, Coverage, ExplanationOfBenefit, Encounter, Procedure, Observation
• OAuth 2.0 Validation: Token validation and scope enforcement tests
• Performance SLA: Response time <1s (95th percentile), bulk export within 5s
• CI/CD Integration: All tests run on every PR with mandatory pass requirement

✅ Prioritized Roadmap:

• 2026 Q2: Patient Access API (Priority 1 - foundational compliance)
• 2027 Q2: Provider Access API (Priority 2 - care coordination)
• 2027 Q4: Payer-to-Payer API (Priority 3 - member transitions)
• 2028 Q2: Prior Authorization API (Priority 4 - workflow automation)

✅ Sandbox Testing: Dedicated Azure sandbox environment with synthetic test data, validated against CMS Blue Button 2.0, Da Vinci PDex, and CARIN BB reference implementations.

✅ Compliance Reporting: Detailed documentation of API coverage, US Core/CARIN BB/Da Vinci IG conformance, timelines, and configuration checklists for auditors and certification bodies.

Implementation Guides Supported:

• US Core v3.1.1 - Patient, Coverage, ExplanationOfBenefit (60% complete)
• CARIN BB v1.0.0 - Consumer Directed Payer Data Exchange (60% complete)
• Da Vinci PDex v1.0.0 - Payer Data Exchange (planned 2027)
• Da Vinci PAS v1.1.0 - Prior Authorization Support (planned 2028)

For Complete Details: See CMS-0057-F Compliance Documentation

💬 Join the Community

• GitHub Discussions: Ask questions & share ideas
• Issues: Report bugs & request features
• Email: early-adopters@aurelianware.com

⭐ Star History

If Cloud Health Office helps your project, give us a star! ⭐

🤝 Contributing

See CONTRIBUTING.md for guidelines.

AI-Assisted Development

Contributors: Install GitHub Copilot in VS Code. Prefix code blocks with detailed comments like ‘// Implement [feature] with [constraints]’. Review AI-generated code for security and compliance. All output must remain HIPAA-safe—redact PHI, never log confidential info, and validate AI completions before merging.

📄 License

Apache 2.0 - See LICENSE for details.

---

🤝 Collaboration and Integration

Cloud Health Office is designed to complement leading core administrative platforms like claims adjudication systems, enabling rapid enhancements to existing workflows without disruption.

---

Cloud Health Office – Advancing Healthcare EDI Integration

**Open Source | Azure-Native | Production-Grade | HIPAA-Compliant