Transforming Clinical Decision Support
Bringing together the clinical and financial to drive appropriate, high-value care
78 % Shorter hospital stays for patients admitted to hospitals using InterQual® Criteria
All Clinical Decision Support Solutions
InterQual® Coordinated Care
Modernize. Connected, automated, and intelligent Clinical Decision Support.
How we help
EHR-integrated Clinical Decision Support to drive effective care
CareSelect® empowers you to benchmark, analyze, and guide provider ordering so you can improve appropriateness, comply with key mandates, and facilitate data-centric utilization management that reveals how inappropriate ordering impacts patient outcomes, costs, and reimbursement.
How we help
Evidence-based criteria and technology to support appropriate clinical decisions
InterQual® provides actionable, evidence-based clinical intelligence and automated processes that enable you to more effectively support appropriate care, align payers and providers, and optimize resources. Our Clinical Decision Support system—including medical review automation—transforms utilization management to be efficient, proactive, and connected.
Automate the prior authorization process to reduce administrative costs and speed care
Our integrated clinical and connectivity solution helps you automate prior authorizations—including those requiring a medical review—within existing payer and provider workflows to reduce administrative burden, speed response times, improve payer-provider collaboration, and minimize interorganizational friction.
Deliver complex care more effectively and efficiently with a personalized care plan
InterQual Coordinated Care is a cloud-based care planning tool that helps you more efficiently manage complex/high-risk cases and create personalized care plans by leveraging patented blended patient assessments that address common care barriers and merge condition components.
- Data and Analytics Discover how our healthcare data analytics solutions help payers and providers turn data into timely, actionable insights to optimize revenue, cost and quality performance. Learn more
- Risk Adjustment Analytics and Services Discover our industry-leading risk adjustment solutions, combined with support and score gap interventions backed by risk adjustment analytics. Learn more
- Value Based Care Enablement Solutions Discover our services, resources, and tools for improving patient care outcomes and efficiencies during a transition to value-based care and reimbursement. Learn more
- Pharmacy Solutions Explore our pharmacy solutions and discover technology that helps automate operations and improve financial results for both independent and chain pharmacies. Learn more