Together, we can build a complete picture of our beneficiaries' health.

Medicaid Connect shares the health histories of our beneficiaries using the Bulk FHIR Protocol, as described in the CMS Interoperability and Patient Access Final Rule (CMS-9115-F). Soon, we will extend our solution to support the requirements of the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). By working together we can collaboratively achieve seamless, interoperable data exchange.

Benefits of NC Medicaid Connect

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Access to Beneficiary Healthcare Data

The Interoperability and Patient Access Rule ensures that beneficiaries can access their health data easily and securely. Our Payer-to-Payer APIs, built on the FHIR (Fast Healthcare Interoperability Resources) standard, provide you with the tools to make this possible. Our APIs provide access to beneficiary, administrative and limited clinical data using the latest industry standards.

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Robust and Secure Development Support

We provide payers with access to our sandbox environment to test applications using mock data. Once an application is ready to access real beneficiary data, we guide them through the requirements of and process for for production access.

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Innovate and Transform Healthcare

This API enables efficient sharing of large volumes of data with NC Medicaid authorized Payers for improved care coordination and value-based care initiatives.

Onboarding and Registration

To start accessing your health information through third-party apps, you must sign up!

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    To start exchanging beneficiary health information, you must register!

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    You will first be asked if you have an NCID. NCIDs are the accounts North Carolinians use to access online state services. You must set one up to register.

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    If you already have an NCID, you will be asked to enter it.

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    If don't have an NCID or would like to use a different one, you may used the the NCID website to register for one.

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    Please register as an organization, only payer organizations may access the Payer-to-Payer API.

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    Once you have your NCID, you may use it to login to this site and complete your registration.

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    During registration, you will enter your organization's information, including contact information and physical address.

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    Once you have completed registration, NC Medicaid will review your application and coordinate next steps with your organization.

Accessing Beneficiary Data

Sandbox Environment

The sandbox environment allows you to test and develop your applications using mock data. Here's how to get access

  1. Complete the registration process.
  2. Once your registration is approved, NC Medicaid will grant you credentials to the sandbox environment.
  3. You may use the sandbox environment to explore and test the Payer-to-Payer APIs.

Production Environment

  1. Once you have thoroughly tested your application in the sandbox environment, you can apply for access to the production environment
  2. Ensure your application complies with NC Medicaid security and privacy standards.
  3. Submit your application for review.
  4. Once approved, you'll receive credentials to access the production payer-to-payer API.

Technical Resources

API Specifications

Our APIs are built on the FHIR (Fast Healthcare Interoperability Resources) standard, ensuring secure and standardized data exchange. Detailed documentation is available to guide you through the integration process:

  1. linkPayer-to-Payer API Documentation: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index
  2. linkFHIR Standards Overview: https://www.hl7.org/fhir/overview.html
  3. linkSMART on FHIR: https://smarthealthit.org/

Tutorials and Learning Resources

  1. linkWhat is FHIR?: https://www.healthit.gov/sites/default/files/2019-08/ONCFHIRFSWhatIsFHIR.pdf
  2. linkAn Introduction to FHIR: https://www.healthit.gov/sites/default/files/2019-08/ONCFHIRFSWhatIsFHIR.pdf
  3. linkFHIR Training Calendar: https://www.hl7.org/training/calendar.cfm
  4. linkFHIR Confluence Home Page: https://confluence.hl7.org/display/FHIR
  5. linkOAuth Simplified: https://www.oauth.com/

Specifications

  1. linkFHIR Specification: https://www.hl7.org/fhir/index.html
  2. linkCARIN Implementation Guide (Blue Button V2): https://www.hl7.org/fhir/us/carin-bb/
  3. linkOAuth 2.0 Specifications: https://oauth.net/specs/

Frequently Asked Questions

Support and Resources

Community Support

NC Medicaid's technology partner, Amida Technology Solutions, Inc. operates a community forum where you may post any technical questions and get a response from either one of Amida's team members or a member of the community. Join the Google Group.

Technical Support

To report any technical or operational issues with the Medicaid Connect Solution, real or suspected, please contact the Medicaid Help Center at 1-866-304-7062. They will ensure that your inquiry is routed and escalated appropriately.