Software
InterQual®
An evidence-based clinical decision support solution for payers, providers, and government agencies who want to help ensure clinically appropriate medical utilization decisions.
Evidence-basedclinical intelligence to support appropriate care
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Support medical necessity decisions
Assess the safest, most efficient care level by using objective, specific criteria based on severity of illness, comorbidities, complications, and the intensity of services delivered.
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Promote clinical quality
Help improve patient outcomes and medical resource utilization by identifying when imaging studies, procedures, DME, MDx tests, specialty medications, and specialty referrals are appropriate.
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Support behavioral health decisions
Support appropriate care by managing your delivery of mental health and substance use care, including initial and concurrent level‐of‐care decisions.
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Improve review workflow and efficiency
Help improve review times and support consistency by integrating third-party content from CMS and other sources into your InterQual workflow.
Provide access to InterQual criteria
Improve usability and transparency by providing multiple InterQual access options to meet any need, from desktop to mobile to cloud.
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