n8n-nodes-change-healthcare

[Velocity BPA Licensing Notice]

This n8n node is licensed under the Business Source License 1.1 (BSL 1.1).

Use of this node by for-profit organizations in production environments requires a commercial license from Velocity BPA.

For licensing information, visit https://velobpa.com/licensing or contact [email protected].

This n8n community node provides comprehensive integration with Change Healthcare's suite of healthcare APIs. With 7 resources covering eligibility verification, claims processing, remittance advice, prior authorizations, EDI transactions, and FHIR patient data management, it enables healthcare organizations to automate critical administrative workflows and improve operational efficiency.

Features

• Eligibility Verification - Real-time insurance eligibility and benefit verification for patients
• Claims Management - Submit, track, and manage healthcare claims processing workflows
• Remittance Processing - Automated processing of Electronic Remittance Advice (ERA) documents
• Prior Authorization - Streamline prior authorization requests and status tracking
• EDI Transaction Handling - Process standard healthcare EDI transactions (270/271, 276/277, 835, 837)
• FHIR Patient Management - Create, update, and retrieve patient records using FHIR R4 standards
• FHIR Clinical Data - Access and manage clinical observations and diagnostic data
• Enterprise Security - Secure API key authentication with healthcare compliance standards

Installation

Community Nodes (Recommended)

1. Open n8n
2. Go to Settings → Community Nodes
3. Click Install a community node
4. Enter n8n-nodes-change-healthcare
5. Click Install

Manual Installation

cd ~/.n8n
npm install n8n-nodes-change-healthcare

Development Installation

git clone https://github.com/Velocity-BPA/n8n-nodes-change-healthcare.git
cd n8n-nodes-change-healthcare
npm install
npm run build
mkdir -p ~/.n8n/custom
ln -s $(pwd) ~/.n8n/custom/n8n-nodes-change-healthcare
n8n start

Credentials Setup

| Field | Description | Required | |-------|-------------|----------| | API Key | Your Change Healthcare API key from the developer portal | Yes | | Environment | Select production or sandbox environment | Yes | | Client ID | Your registered application client identifier | Yes | | Base URL | Override default API base URL if needed | No |

Resources & Operations

1. Eligibility

| Operation | Description | |-----------|-------------| | Check Eligibility | Verify patient insurance eligibility and benefits | | Get Eligibility Status | Retrieve status of previous eligibility requests | | Batch Eligibility Check | Process multiple eligibility verifications |

2. Claims

| Operation | Description | |-----------|-------------| | Submit Claim | Submit new healthcare claims for processing | | Get Claim Status | Check the status of submitted claims | | Search Claims | Search claims by various criteria | | Update Claim | Modify existing claim information | | Cancel Claim | Cancel a previously submitted claim |

3. Remittance

| Operation | Description | |-----------|-------------| | Get Remittance | Retrieve Electronic Remittance Advice documents | | List Remittances | Get list of available remittance documents | | Parse ERA | Parse and extract data from ERA files | | Download ERA | Download ERA documents in various formats |

4. Prior Authorization

| Operation | Description | |-----------|-------------| | Submit Authorization | Submit new prior authorization requests | | Check Auth Status | Get status of authorization requests | | Update Authorization | Modify existing authorization requests | | Cancel Authorization | Cancel pending authorization requests | | List Authorizations | Retrieve list of authorizations |

5. EdiTransactions

| Operation | Description | |-----------|-------------| | Send EDI Transaction | Submit EDI transactions (837, 270, 276) | | Receive EDI Response | Retrieve EDI response transactions (271, 277, 835) | | Validate EDI | Validate EDI transaction format and content | | Track Transaction | Monitor EDI transaction processing status | | Batch EDI Processing | Handle multiple EDI transactions |

6. FhirPatients

| Operation | Description | |-----------|-------------| | Create Patient | Create new patient record using FHIR R4 | | Get Patient | Retrieve patient information by ID | | Update Patient | Modify existing patient record | | Search Patients | Search patients by demographics | | Delete Patient | Remove patient record | | Get Patient History | Retrieve patient record version history |

7. FhirObservations

| Operation | Description | |-----------|-------------| | Create Observation | Add new clinical observation | | Get Observation | Retrieve observation by ID | | Update Observation | Modify existing observation | | Search Observations | Search observations by patient, date, code | | Delete Observation | Remove clinical observation | | Batch Observations | Process multiple observations |

Usage Examples

// Check patient eligibility
{
  "subscriberId": "123456789",
  "memberDateOfBirth": "1990-01-15",
  "providerNPI": "1234567890",
  "serviceDate": "2024-01-15"
}

// Submit professional claim
{
  "claimType": "professional",
  "patientId": "PAT001",
  "providerId": "PRV001",
  "serviceLines": [
    {
      "procedureCode": "99213",
      "chargeAmount": 150.00,
      "serviceDate": "2024-01-15"
    }
  ]
}

// Create FHIR patient
{
  "resourceType": "Patient",
  "name": [
    {
      "family": "Smith",
      "given": ["John", "Robert"]
    }
  ],
  "gender": "male",
  "birthDate": "1990-01-15",
  "identifier": [
    {
      "system": "http://hospital.org/patients",
      "value": "PAT001"
    }
  ]
}

// Submit prior authorization
{
  "patientId": "PAT001",
  "providerId": "PRV001",
  "serviceCode": "99285",
  "requestedDate": "2024-02-01",
  "clinicalInfo": "Emergency department visit for chest pain"
}

Error Handling

| Error | Description | Solution | |-------|-------------|----------| | 401 Unauthorized | Invalid or expired API credentials | Verify API key and client ID in credentials | | 429 Rate Limited | Too many requests in time window | Implement delay between requests or use batch operations | | 400 Bad Request | Invalid request format or missing required fields | Validate input data against API documentation | | 404 Not Found | Requested resource does not exist | Check resource IDs and ensure they exist in the system | | 500 Internal Server Error | Change Healthcare service error | Retry request after delay or contact support | | Network Timeout | Request timed out | Increase timeout settings or check network connectivity |

Development

npm install
npm run build
npm test
npm run lint
npm run dev

Author

Velocity BPA

• Website: velobpa.com
• GitHub: Velocity-BPA

Licensing

This n8n community node is licensed under the Business Source License 1.1.

Free Use

Permitted for personal, educational, research, and internal business use.

Commercial Use

Use of this node within any SaaS, PaaS, hosted platform, managed service, or paid automation offering requires a commercial license.

For licensing inquiries: [email protected]

See LICENSE, COMMERCIAL_LICENSE.md, and LICENSING_FAQ.md for details.

Contributing

Contributions are welcome! Please ensure:

1. Code follows existing style conventions
2. All tests pass (npm test)
3. Linting passes (npm run lint)
4. Documentation is updated for new features
5. Commit messages are descriptive

Support

• Issues: GitHub Issues
• Change Healthcare API Docs: Change Healthcare Developer Portal
• FHIR R4 Specification: HL7 FHIR R4