Convert enrollment forms to EDI 834, automatically
Hewto.ai is enrollment form OCR software and a healthcare enrollment OCR API purpose-built for insurance enrollment — turning scanned, faxed, and handwritten enrollment forms into validated ANSI X12 834 Benefit Enrollment and Maintenance files. End-to-end enrollment intake, from paper to 834 EDI.
Watch Hewto.ai process an enrollment form in real time
A walkthrough of ingesting, extracting, and validating an insurance enrollment form — from scan to 834-ready structured data.
Enrollment form OCR software
Layout-aware OCR reads scanned, faxed, and photographed insurance enrollment forms at any quality — including handwriting, checkboxes, and signatures.
Insurance enrollment data extractor
Extracts every field of the member enrollment form: subscriber demographics, dependents, coverage elections, group and policy numbers, and effective dates.
Validation & eligibility edits
Applies SSN, date, plan code, and dependent relationship checks with per-field confidence scoring before data reaches your benefits system.
Clean output & APIs
Delivers structured JSON or 834-ready data to your benefits administration platform, TPA, or carrier eligibility system.
Why Hewto.ai outperforms traditional enrollment form OCR
We don't use character-by-character OCR. Hewto.ai runs an agentic document extraction pipeline built on vision-language models fine-tuned specifically for insurance enrollment forms. The model reads the form the way a trained benefits administrator does — looking at the whole document, its layout, and every visual cue — so it captures the elections and dependents a traditional OCR engine silently misses.
Vision-first, not character-first
A VLM sees the form as a whole — election checkboxes, plan tables, dependent blocks, signatures, and overlapping handwriting — instead of stitching guesses letter by letter. Visual context stays intact.
Fine-tuned on enrollment forms
Our models are fine-tuned on real insurance enrollment forms across carriers, layouts, and handwriting styles. They know a dependent block is a family member — not just a grid of characters — so extractions map cleanly to fields, not raw text.
Agentic reasoning, per field
Each field runs through a purpose-built agent that verifies context, cross-checks related sections, and self-corrects when something looks off — the kind of judgment a deterministic OCR pipeline simply can't make.
- Coverage election checkboxes and waiver tick-marks
- Handwritten SSNs, dates of birth, and signatures
- Dependent blocks with ambiguous relationships
- Plan and tier selections buried in dense tables
- Qualifying life event details written in margins
- Effective dates conflicting across form sections
- Every election checkbox — including partially marked ones
- Handwriting in any field, including SSNs and signatures
- Dependents and beneficiaries with correct relationships
- Plan, tier, and coverage level for every line of coverage
- Margin notes and life event details assigned to the right field
- Date conflicts flagged with per-field confidence scores
Fine-tune a vision-language model at the click of a button
Hewto.ai provides vision-language model fine-tuning at the click of a button. Upload a handful of labeled samples of enrollment forms — or any new form variant, payer template, or document type you handle — and Hewto.ai fine-tunes a purpose-built VLM for it. No ML team, no training pipelines, no infrastructure to manage.
- Upload samples, click fine-tune, ship
- No ML engineers or training pipelines required
- Custom accuracy on your document mix
- Ready to run in minutes, not weeks
- 01Upload labeled samplesDrop in 20–200 examples of your target form.
- 02Click Fine-tuneHewto.ai kicks off a fine-tuning run — no config, no code.
- 03Ship the modelYour custom VLM goes live behind the same API endpoint.
Every section of the enrollment form
As a complete insurance enrollment data extractor, Hewto.ai captures every section of the enrollment form — so nothing is re-keyed by hand during open enrollment or new hire onboarding.
- Subscriber demographics: name, SSN, DOB, address
- Dependent & beneficiary details with relationships
- Coverage elections: medical, dental, vision, life plans & tiers
- Effective dates, qualifying life events & signatures
Group Health Enrollment Form
2026 Plan Year · Medical / Dental / Vision
Convert enrollment forms to X12 834
Hewto.ai parses enrollment forms and generates a compliant ANSI X12 834 Benefit Enrollment and Maintenance file. Every section is mapped through an enrollment form to EDI 834 crosswalk, so a scanned or faxed form becomes clean, submittable EDI with no manual keying.
Enrollment form → X12 loop / segment mapping
- Subscriber demographics → Loop 2000 (INS, NM1*IL)
- Dependents → member-level Loop 2000 (INS*N, NM1*03)
- Coverage elections → HD segments (Loop 2300): medical, dental, vision
- Effective & termination dates → DTP 356 / 357 segments
- Group & policy numbers → REF*0F / REF*1L segments
ST*834*0001*005010X220A1~ BGN*00*ENROLL20260101*20260101~ INS*Y*18*030*XN~ REF*0F*GRP12345~ NM1*IL*1*DOE*JOHN****34*XXX4321~ INS*N*01~ NM1*03*1*DOE*JANE~ HD*030**PPO-GOLD~ DTP*356*D8*20260101~
Generated automatically from a scanned enrollment form — image to 834 EDI file.
Enrollment data extraction software for real-world intake
Enrollment digital mailroom
Auto-classify and process every enrollment form hitting your fax lines and mailroom — built to absorb open enrollment season volume spikes.
Handwritten enrollment extraction
AI handwriting recognition captures hand-filled names, SSNs, and dates that defeat traditional OCR.
Checkbox & election capture
Reads plan options, coverage tiers, waiver checkboxes, and tick-marks — including partially marked selections.
Paper enrollment to 834
Convert scanned and faxed enrollment forms into compliant ANSI X12 834 Benefit Enrollment and Maintenance files automatically.
Enrollment form parsing API & healthcare enrollment OCR API
Integrate enrollment capture directly: an X12 834 generator from paper-form JSON/XML, and an SDK to convert image to 834 EDI.
Enrollment form parsing API
A healthcare enrollment OCR API that parses enrollment forms to ANSI 834 — POST an image, receive structured JSON/XML in response.
SDK: convert image to 834 EDI
Drop-in SDK to convert an enrollment form image to 834 EDI, backed by an X12 834 generator from paper-form JSON/XML.
Automated enrollment intake BPO
Offload high-volume paper enrollment intake — automated enrollment intake BPO with human-in-the-loop QA and SLAs.
Insurance enrollment data extraction, answered
Common questions about Hewto.ai's enrollment form OCR software and insurance enrollment data extractor for paper and faxed enrollment forms.
Ready to see Hewto.ai on your documents?
Book a personalized demo and watch us process your HCFA, UB-04, and dental claims live.