# FAQ template

Recommendation
Tailor the template below to meet your needs before publishing on your website or in member communications.

> ## Payer-to-Payer data exchange: you're in control of how your health data follows you
When you move to a new health plan or have more than one insurer, your medical information shouldn't get lost. The CMS Payer-to-Payer data exchange lets your plans securely share your recent health data - but only if you choose to allow it.
## Who controls this data exchange?
You control whether we request your health care data from your previous insurer or exchange data with your concurrent insurers through the API. By default, you are opted-out so no data is shared.
When you opt-in, you give your plan permission to securely request and exchange information that supports your ongoing care. You can opt-out again at any time.
## Why should I consider opting in?
Opting into data sharing has several potential benefits including
* improved completeness of your medical records if you change insurance carriers,
* reduction in care disruptions,
* faster approvals for treatments,
* better coordination between plans.

## How does it work?
You are opted out by default so no data is shared automatically. During the opt-in process, you choose to share data and provide details about your former or concurrent insurers.
If you give us information about your last insurer, we will ask them for your data. This means you will continue to have access to those records in the same place as your new records.
We can request up to five years of your health data from your previous plan. If you have two more more insurers, we will exchange your data with them at least every three months to ensure we can work with them to align your coverage as best as possible.
Even if you opt-in, your data will not be shared with insurers that you are not enrolled with. This API data exchange will only be used to receive data from your previous insurer, exchange data with your concurrent insurer, and send to your future insurer (as appropriate).
## When does data exchange happen?
Data exchange only happens if you decide to opt in and give your permission to your health plan. Once you provide consent and identify your former or concurrent plans, your plan can securely request your data from those insurers and continue updating information as needed.
## Do I need to do anything?
By default, you are opted out of the Payer-to-Payer data exchange. If you want your data shared, you must opt-in and provide details about your former or concurrent insurers.
Once you opt-in, no further action is needed. This process happens automatically between health plans using secure, standardized systems. You'll still have access to your information through your plan's member portal or existing health apps. If you later decide you no longer want your information shared, you can opt-out at any time while you are enrolled.
## How do I opt-in?
Either choose one of the options below or insert your custom opt-in process. Include only the relevant process choice below by deleting one section entirely and the header (h3) for the chosen section.
### Option 1: Process for members if you (the payer) have configured IdP integration for opt-in
1. Click on the opt-in link in your member portal.
2. Review the educational materials presented to you and click Continue.
3. Choose whether you would like to Opt-in or Opt-out of the Payer to Payer Data Exchange then click Next. If you choose to Opt-in continue to the next step. If you choose to Opt-out you may return to your member portal.
4. Search for your health plan and select it. You can manually enter your health plan's information if you don't see it in the search results.
5. Enter your Member ID for that health plan.
6. Select the year your coverage with that health plan ended or will end.
7. Repeat steps 4 through 6 until you have selected all the health plans that you want to request data from.
8. Click Confirm. A confirmation page is displayed to let you know that you have opted-in successfully.

### Option 2: Process for members if you (the payer) have not configured IdP integration but still use 1upHealth for opt-in
1. Click on the opt-in link in your member portal.
2. Click Register.
3. Enter the information required to create an account and click Register.
4. Review the educational materials presented to you and click Continue.
5. Choose whether you would like to Opt-in or Opt-out of the Payer to Payer Data Exchange then click Next. If you choose to Opt-in continue to the next step. If you choose to Opt-out you may return to your member portal.
6. Search for your health plan and select it. You can manually enter your health plan's information if you don't see it in the search results.
7. Enter your Member ID for that health plan.
8. Select the year your coverage with that health plan ended or will end.
9. Repeat steps 6 through 8 until you have selected all the health plans that you want to request data from.
10. Click Confirm. A confirmation page is displayed to let you know that you have opted-in successfully.

## Is my data secure?
Your health care data is protected by privacy and security measures. All sharing uses the FHIR standard - a nationally recognized framework for secure, structured data exchange.
When you opt-in, information is shared only with insurers that cover you now, have covered you in the past, or will cover you in the future.
## The bottom line
You are always in control of your health data. Opting-in helps your care continue smoothly when you change plans, improves coordination, and ensures your information stays accurate and secure. You can opt-in or opt-out any time.