Skip to main content

Today, there seems to be some confusion and uncertainty going around the healthcare industry about the new North Carolina HIE called HealthConnex. For those of you who don’t know, an HIE is a health information exchange or a secure, electronic network where healthcare providers can share and access medical information statewide.

Recently, the North Carolina General Assembly created an organization called the North Carolina Health Information Exchange Authority (NC HIEA) with an advisory board to oversee HealthConnex.

Who Is Required to Connect to HealthConnex?

  • Anyone in healthcare who provides Medicaid services and has an electronic health record (EHR) system including:
    • Physicians who practice under Chapter 90 Article 1 of General Statutes
    • Physician assistants [21 NCAC 32S .0201]
    • Nurse practitioners [21 NCAC 36 .0801]
    • Hospitals [G.S. 131E-176 (3)]
  • Managed Care Organizations (MCOs) and Local Management entities (LMEs)
  • Prepaid Health Plans (PHPs) [S.L. 2015-245]
  • Other Medicaid and state-funded service providers

When Is the Deadline to Connect?

  • Physicians, physician assistants, nurse practitioners and hospitals (listed above) must connect by June 1, 2018.
  • All other providers as stated above must connect by June 1, 2019.
  • Claims and encounter data must be submitted by LMEs and MCOs no later than June 1, 2020.

What Does It Mean to Be Connected?

Patient information pertinent to Medicaid services provided (and other state-funded care) must be sent to HealthConnex twice per day either directly or by a hub.

Does It Cost Anything to Connect to HealthConnex?

It does not cost anything to submit data to HealthConnex. In the future, there may be fees for certain features. Those fees will be determined by the advisory board and then will be recommended to the NC General Assembly. However, certain EHR vendors may charge.

How Do I Connect?

  1. Review and sign the Participation Agreement.
  2. Prepare your EHR or other technology to connect to the HIE.
  3. Determine 3 people from your organization who’ll be the main points of contact.

Can I Use Any EHR?

In order to properly connect to HealthConnex, your EHR must be able to send version 2 and higher HL7 messages. ONC certified preferred.

>Why Is There a New Contract to Sign?

As of February 29, 2016, all previous contracts were terminated because they were signed with a different agency. North Carolina created a new agency to oversee the HIE. In order to connect, you must sign a new contract with the latest stage agency, NC HIEA.

Why Is There a New Participation Agreement?

The NC HIEA changed the participation agreement to be in line with the restatement I of DURSA, Data Use and Reciprocal Support Agreement. However, you do not have to sign the new participation agreement to connect if you have already signed one with the NC HIEA.

Should I Be Concerned About PHI and the NC HIE?

HealthConnex is in accordance with HIPAA requirements. All organizations receiving PHI have entered into Business Associate Agreements. Plus, the state can audit those organizations as need be. No data will be sold.

If you have any other questions about HealthConnex, you can visit or you can fill out the form below for a free consultation with one of our healthcare experts.

Fill Out the Form to Get Your Free Healthcare Consultation on the NC HIE, HealthConnex.