Thursday, 21 March 2019

Attention Providers Who Submit Medical Claims to North Carolina State-Funded Payers

Posted in ADA News

Attention Providers Who Submit Medical Claims to North Carolina State-Funded Payers

Many of you may have been receiving correspondence from NC Health Connex. Please make sure that you immediately review any of the correspondence received from NC HealthConnex as this correspondence will impact reimbursement in your state.

Effective June 1, 2019, all health care providers who receive funds from the State of North Carolina (e.g., Medicaid, Vocational Rehabilitation, Services for the Blind, NC Health Choice, State Health Plan, etc.) for the provision of health care services must connect to NC HealthConnex by specific dates in 2018 and 2019 to continue to receive payments for services provided.

NC HealthConnex is a secure electronic network that facilitates conversations between health care providers, allowing them to access and share health-related information across the state.

Created by the North Carolina General Assembly, NC HealthConnex is the state-designated health information exchange. It is managed by the North Carolina Health Information Exchange Authority (NC HIEA), housed within the N.C. Department of Information Technology.

In order to participate in this program, providers must have EMRs/EHRs that are minimally capable of sending HL7 messages, version 2 and higher. EHR products that are ONC-certified for Meaningful Use for Centers for Medicare & Medicaid Services (CMS) Incentive Programs are preferred. The NC HIEA has also created a technology specification and minimum data target that can be found here. This document can also be used to ensure that your EHR vendor can meet our technology standards. Audiologists will also have to complete Participation Agreements with NC Health Connex, which is the contract that governs the data sharing between the health care provider and the NC HIEA. This agreement can be found on our website with instructions for completion. For more information, visit the How to Connect page.

Audiologists need to reach out to your EMR/EHR or office management system vendor to see if their systems can or do comply with the outlined standards. You can learn more about the technology and connectivity standards here.

If you and your practice feel you may need an extension because you cannot meet the June 1, 2019 compliance and implementation deadline, please follow the process outlined on the Extension Process page.

Please go to the NC Health Connex site for more information at https://hiea.nc.gov/.

For questions, please contact Kim Cavitt at kim.cavitt@audiologyresources.com or 773-960-6625.