NC HealthConnex Bidirectional Interface Confirmation Form

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The N.C. Health Information Exchange Authority can help determine whether your practice participates in a bidirectional exchange with a health information exchange to support care transitions. The Centers for Medicare & Medicaid requires that clinicians and groups do so to be eligible for the Merit-Based Incentive Payment System.

Submit the form below to receive confirmation of your bidirectional connection to NC HealthConnex.

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Organization Information

Organization Contact

Provide your organization's 10-digit national provider number.

Participant Account Administrator Information

HIEA will direct further communication to this email address.

Electronic Health Records Vendor Information