Your Choices

Opting Out of the HIE Versus Patients' Restricting Disclosures Under HIPAA

The NC General Assembly has provided patients a way to prevent information submitted to NC HealthConnex to be shared between participating health care providers, called “Opt Out.” If a patient submits an Opt Out form to the NC HIEA, any information relating to that patient maintained in the NC HealthConnex system will be blocked from being accessed by health care providers who attempt to look up that patient.

Please be aware:

  • Opting out of NC HealthConnex will not adversely affect your treatment by your physician, and you cannot be discriminated against if you do decide to opt out.
  • If you change your mind about participating in NC HealthConnex, you can opt back in at any time by completing a new form and checking “Rescind Opt Out.”
  • If you choose to opt out, please complete the “Opt Out” form linked below. Your provider may also be able to provide a form to you. If you are under the age of 18, please note the NC HIEA will not process your Opt Out unless your parent or legal guardian has signed your Opt Out Form, or you have been emancipated.

Please note that submitting an Opt Out Form does not mean your data will not be submitted by your health care provider(s) to NC HealthConnex. Providers who receive Medicaid or State funds for the provision of health care services are required by law to send data pertaining to health care services that are funded by the State, including through Medicaid or State Health Plan. If you do not want your data to be disclosed to NC HealthConnex, you may be able to request that your provider restrict the submission of your data. Please discuss this with your provider and refer to their policies on restricting disclosures of patient data for treatment, payment, and health care operations as permitted under HIPAA. Please see 45 C.F.R. 164.522(e)(3)(i).

If you are under the age of 18 and you receive treatment for (i) venereal disease and other reportable diseases, (ii) pregnancy, (iii) abuse of controlled substances or alcohol, and (iv) emotional disturbance, you may be able to request that this information not be disclosed by your provider to NC HealthConnex depending on your health care provider's policies. Please discuss this with your provider. See N.C.G.S. 90-21.5 (Minor's consent sufficient for certain medical health services) and 145 C.F.R. §164.502 of HIPAA.

If you choose to opt out, please complete the “Opt Out” form linked below. Your provider may also be able to provide a form to you.

Complete the form and mail it to:

NC Health Information Exchange Authority
Mail Service Center 4101
Raleigh, NC 27699-4101

Opt Out form in English

Optar pas no en Espanol