Change Healthcare InterQual AutoReview is now Available with Conduent Midas Care Management System

 In Health Informatics, Interoperability, Productivity & Management

Conduent Midas Care Management users can now access medical reviews that have been automatically populated from the EHR–greatly reducing administrative burden of case managers

Change Healthcare has announced that Conduent, the world’s largest provider of diversified business process services, has integrated the Change Healthcare Medical Review Service into its Midas Care Management application and into the workflow of its users. With this integration, Midas Care Management is now “InterQual AutoReview™ ready,” enabled to receive medical reviews completed automatically and supported with data pulled from the electronic health record (EHR).

InterQual AutoReview, a SaaS, Robotic Process Automation (RPA) application, automates the InterQual medical review by extracting clinical data from leading EHRs, embeds clinical results and transmits directly to InterQual Connect’s Medical Review Service, seamlessly integrating into the case manager’s Conduent Midas Care Management Solution workflow. The result is automated, evidence-based clinical decision support within workflows and access to clinical data, helping to ensure that patients receive the most appropriate care while freeing clinicians from the burden of manual medical reviews.

“At Change Healthcare, we continue to invest in emerging technologies to drive innovation that truly makes a difference,” said Rod O’Reilly, EVP and president, Software & Analytics, Change Healthcare. “Technologies such as RPA accelerate capabilities that allow our customers to reduce their administrative burden, manage costs, and focus on the patient—elements that bend the cost curve for healthcare as the industry continues its shift to value-based care.”

“The ability to have medical reviews completed automatically and sent directly to the care management workflow saves time and helps our users focus on the timely delivery of care,” said Lu Calkins, vice president, Midas Health Analytics Solutions, Conduent. “We are committed to providing value to providers and payers as we continue to innovate and invest in solutions that use patient-centric data to improve clinical and financial outcomes.”

Along with enabling InterQual AutoReview, the Medical Review Service provides Conduent users with a new, enhanced InterQual user interface. It also provides access to the most current clinical criteria—available as soon as they are published to the cloud—and ensures transparency in the prior authorization process with custom policies published by connected payers.

For the past nine years, Change Healthcare has commissioned and published an annual survey of health plan leaders and other healthcare organizations reporting on the “pulse” of the healthcare industry. The 2019 study, produced in partnership with the HealthCare Executive Group (HCEG), aims to define and...

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