How to Connect to NC HealthConnex

North Carolina has passed a law that requires all services funded by state dollars to be reported to the state health information exchange (HIE), also known as NC HealthConnex. TherapyNotes supports this requirement by allowing you to submit basic encounter data to the HIE. Once connected, TherapyNotes will automatically queue and submit the required data to NC HealthConnex every time a note is signed and saved to a patient chart. This means there's no additional work necessary on your part to remain compliant with NC HealthConnex data submission requirements. There are several steps to take to complete this connection.

What Type of Information is Sent to NC HealthConnex?

TherapyNotes has reached an agreement with NC HealthConnex to meet minimum necessary data standards that comply with the NC HealthConnex Privacy and Security Policy and the Behavioral Health Sensitive Data Policy. We aim to protect your client’s privacy while still allowing you to remain compliant with the spirit and letter of the law. In essence, the same data that is included in a health insurance claim is the data that is submitted to NC HealthConnex. This includes information such as patient and provider demographics, encounter information such as the date and time of the session, service codes, and the patient’s diagnosis code. TherapyNotes marks all patient diagnosis codes as confidential. This is supposed to hide the patient’s diagnosis code from any other user of the HIE unless the user affirmatively indicates a need-to-know of the diagnosis. While the law does allow a patient to opt-out of data sharing from HealthConnex, the law still requires providers to submit the patient data to HealthConnex.

Step 1: Complete a Participation Agreement with NC HealthConnex

Since connecting to NC HealthConnex will require the submission of protected health information, you must complete a Participation Agreement prior to enabling the connection in TherapyNotes.

NC HealthConnex offers two types of Participation Agreements:

The Full Participation Agreement allows a participant to gain full use of all the NC HealthConnex current and future value-added features. This includes features like a Direct secure email account and the ability to look up information within the HealthConnex Portal.
The Submission-Only Agreement allows a participant to meet minimum requirements for submitting data to NC HealthConnex but does not allow for the use of any value-added features.

Currently, TherapyNotes supports the submission of data to NC HealthConnex consistent with the Submission-Only Agreement. If you wish to take advantage of other features with the Full Participation Agreement, you may do so outside of TherapyNotes.

Step 2: Enable Data Submission for Appropriate Payers

Role Required: Practice Biller

Because data submission is limited to only those encounters that are funded by state dollars, you must enable the feature for select payers for which you provide services. Payers that are eligible to participate in the NC HealthConnex data exchange are:

NC Medicaid (SKNC0)
Alliance Behavioral Health (NC) (23071)
East Pointe Behavioral Health (08044)
Partners Behavioral Health Management (52613)
Sandhills Center (SHC30)
Vaya Health (VAYAH)
Cardinal Innovations Healthcare Solutions (06607)
Trillium Health Resources (56089)
Blue Cross and Blue Shield of North Carolina (SB810)
Wellcare Health Plans (14163)
UnitedHealthcare Community Plan of CA, DC, DE, FL, GA, HI, KY, LA, MA, MD, NC, NM, OH, OK, PA, RI, VA, WA (87726)

To enable HIE data submission with each of these payers:

Click Payers > Payer Name > HIE tab
Check the box to Enable Data Submission.
Enter the Organization ID provided to you by NC HealthConnex.
Select the default Submission Status for all patients assigned to this payer.

Note: If the majority of patients with this payer will need to have their information submitted to NC HealthConnex, select Submit data unless not allowed by individual patient's Billing Settings. If only a few patients assigned to this payer will need to have their information submitted to NC HealthConnex, select Do not submit data unless allowed by individual patient's Billing Settings.

Click the Save Changes button.

Step 3: Configure Submission Status Per Patient

Role Required: Practice Biller or Biller for Assigned Patients Only

For some patients, you may need to override the payer's default Submission Status. An example would be with Blue Cross Blue Shield of North Carolina. Only patients with the State Health Plan would need to have their information submitted to NC HealthConnex, so you may choose Do not submit data unless allowed by individual patient's Billing Settings as your default submission option for this payer. For each patient with the State Health Plan, you would override this default to submit the required data to NC HealthConnex.

To override a payer's default HIE Submission Status:

Click Patients > Patient Name > Billing Settings tab
Click anywhere on the Insurance box to edit.
From the HIE dropdown, select Do not submit data to HIE or Submit data to HIE according to your submission requirements for that patient and payer.
Click the Save Changes button.