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?

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.

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