Be the first to query nationwide exchange for Payment purposes
Through Health Gorilla’s QHIN, organizations can:
- Streamline key workflows such as prior authorization and risk adjustment
- Access additional value-add solutions, such as national ADT alerts and historical lab data
- View patient data in a single organized, longitudinal record
Get notified when the Payment exchange purpose under TEFCA becomes available.
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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 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.
Benefits for Health Care Providers Across the Continuum
TEFCA will enhance provider access to health information to support better clinical decision-making, improved outcomes, and lower costs.
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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.