An evidence-based clinical decision support solution for payers, providers, and government agencies who want to help ensure clinically appropriate medical-utilization decisions
Evidence-basedcriteria and technology to support appropriate clinical decisions
Evidence-based InterQual Criteria to support appropriate care decisions
Make the safest, most efficient care decisions by using objective, specific criteria for both medical and behavioral health across all levels of care, as well as ambulatory care planning. InterQual Criteria are produced using a rigorous development process based on the principles of evidence-based medicine (EBM) to give you complete confidence in the guidance provided.
Industry content structured for UM to drive consistent, efficient reviews
Streamline your medical review process by giving users easy access to industry content, such as The ASAM Criteria® and Medicare policies, that have been converted into a structured, interactive tool.
Technology solutions to enable InterQual Criteria use
Get easy access to the InterQual Criteria, streamline your medical review process, and provide transparency with the access options that best meet your needs.
Optimize your InterQual solutions
Make the most of the InterQual solutions you use with our education, IRR, and customization solutions. Rigorous and effective education options help meet your staff-development needs, and the Interrater Reliability web-based tool helps improve usage and quality within your organization.
- InterQual AutoReview with Predictive Analytics Learn about InterQual AutoReview, our automation solution that leverages the EHR to complete InterQual medical reviews automatically, instantly, and accurately. Learn more
- InterQual Connect Discover InterQual Connect, a medical review & connectivity solution that enables the automation of prior authorizations requiring medical review. Learn more
- InterQual Coordinated Care Discover our cloud-based care coordination solution that helps with complex care management of high-risk members and patients with a single, blended care plan. Learn more