October 2019 Accredited Bundle Interop results submission form
Please select the Sending HISP (your HISP)
Note: 2-Cert Addresses (Single use certificates) are specified at the end of the list.
Applied Research works/ Cozeva
Dept. of Veterans Affairs
Indian Health Service
Orion Health Ltd
Secure Exchange Solutions
The Health Collaborative
2-Cert Address Anthem
2-Cert Address EMR Direct
2-Cert Address iShare Medical
2-Cert Address MaxMD
2-Cert Address SES
Optional contact name and regular email address
If the field is left blank, DirectTrust will utilize the contact information listed on the DirectTrust Interop Directory if further information is needed about the reported result(s).
If multiple POSITIVE tests are being reported, please select the second option below. To use the standard single test response (can be used for all reports), please choose the first option.
For Multiple results form: Testing MUST meet all criteria: 1. Message was sent to this counter party (left my system without immediate fail). 2. Processed MDN was Received and Usable by my system. 3. Beyond the MDN: Counter party confirmed the message I sent to them was received and its payload could be incorporated (if receiving system is an EHR endpoint) OR was readable (if receiving system is a HISP endpoint). Counter party may alternatively confirm this in their own report.
Only one / Standard form
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