TEFCA for Payment

TEFCA for Payment

The Trusted Exchange Framework and Common Agreement (TEFCA) aims to establish a floor of universal interoperability across the country. How does the framework help payment use cases?

Watch the webinar to learn more about our QHIN

Be the first to query nationwide exchange for Payment purposes

Through Health Gorilla’s QHIN, organizations can:

Get notified when the Payment exchange purpose under TEFCA becomes available.

Benefits of TEFCA for payers

The Payment exchange purpose under TEFCA enables payers to efficiently access and exchange health information across the country. Payers can use this data to facilitate improved care coordination and case management, streamline workflows such as prior authorization, and assist with risk adjustment and other payment initiatives.

Improved case management

Under TEFCA’s permitted exchange purpose of Payment, health plans can have a comprehensive view of a member’s care, leading to better case management and care coordination.

Quality improvement data collection

TEFCA supports the collection of data for quality improvement, enabling health plans to track performance and report to government programs or sponsors.

Enhanced risk adjustment

By exchanging health information nationwide, payers can streamline HCC reporting and increase reimbursements with access to members’ comprehensive medical records.

Is your organization ready for TEFCA and the CalHHS DxF?

As the nation’s only dual-designated QHIN and QHIO, Health Gorilla helps health care organizations comply with state mandates for data sharing, capture federal regulatory incentives, and share health information under permitted exchange purposes, including treatment.

Learn more about our QHIN Learn more about our QHIO

Learn more about Payment



User’s Guide to the Trusted Exchange Framework and Common Agreement

Learn more about the goals of TEFCA, QHINs, permitted exchange purposes, and security and privacy requirements.

Download ](/content/blog/how-tefca-and-qhins-will-benefit-patients-providers-payers-and-public-health/index.html)

Benefits for Health Care Providers Across the Continuum

Download

TEFCA will enhance provider access to health information to support better clinical decision-making, improved outcomes, and lower costs.](https://rce.sequoiaproject.org/benefits-for-health-care-providers-across-the-continuum/)



Uses and Disclosures for Treatment, Payment, and Health Care Operations

Read more ](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html)

How TEFCA and QHINs Will Benefit Patients, Providers, Payers, and Public Health

Read more ](/content/home/content/tefca-and-ehrs/index.html)

The TEFCA Effect: How QHINs Will Boost Interoperability for EHRs and Benefit Patients

Download white paper ](https://cdn.prod.website-files.com/62719a041d28d7b5603dd995/65724d6b5371bebca5e162e2_Common-Agreement-Users-Guide-version-1.1-dated-2.9.2023.pdf)

Secure and trusted

HITRUST R2

We’re HITRUST R2 certified, which means that we successfully manage cybersecurity risks by exceeding industry-defined information security requirements.

SOC 2 Type 2

SOC 2 Type 2 is a stamp of approval on our controls relevant to data security, availability, processing, integrity, confidentiality, and privacy.

HIPAA

Complying with applicable health data laws, including HIPAA, is ingrained in our culture, processes, and staff training.

Get started today

Get in touch with our interoperability experts to learn more.

Get in touch