InterQual® Coordinated Care
An integrated, cloud-based care coordination solution that helps payers and providers offer complex care management of high-risk members and patients with a single, blended care plan.
ManageHigh-risk and Complex Cases
- Assess and manage complex cases efficiently with a single, blended care plan, created from a patented assessment that merges condition components.
- Manage care holistically with assessment questions covering medical, behavioral, and social needs, in addition to comorbidities and cross-condition issues.
- Enable evidence-based decision making with content developed with the same clinical integrity and standards as InterQual Criteria.
- Streamline case management with a SaaS solution that is integrated into your existing workflow, offering greater efficiency, timely alerts, and support for clinician delivery of quality, appropriate care.
- Create a tailored care management program to better control the medical costs of high-risk members and patients, help prevent readmissions and improve clinical outcomes.
- Meet regulatory requirements with a solution that is URAC accredited for both for care management and disease management. The solution helps you meet NCQA PHM5, MBHO QI9, and SNP requirements.
Integrated Assessments and Patient Information
- Provide assessments in simple Q&A format, including a Primary Assessment, which addresses common care barriers and can include multiple components.
- Leverage 40 condition-focused modules, industry-validated screening tool assessments, plus additional stand-alone assessments: High Risk Neonate and Caregiver Discharge, Long-Term Services and Support, Palliative Care, Readmission Reduction, and Social Determinants of Health assessments.
- Integrate our cloud-based solution into homegrown or third-party care management delivery systems.
- Leverage the SaaS architecture to provide access throughout a networked system – without increasing IT burden.
- Gain real-time access to content and software upgrades without waiting for installation and validation, while maintaining control of upgrade timelines.
Support for case managers and members/patients
- Help improve member/patient education with materials to guide case managers through the consistent presentation of condition-related information.
- Reinforce education concerning specific conditions and condition management with companion member- and patient-facing fulfillment materials.
Explore related solutions
- InterQual® Level of Care Criteria Assess the safest and most efficient care level based on severity of illness, comorbidities, complications, and the intensity of services being delivered. Learn more
- InterQual® Optimization Solutions Clinical education, interrater reliability, and solutions for InterQual optimization clients who want to get the most from their InterQual solution. Learn more
- InterQual® Behavioral Health Criteria Discover how to manage the delivery of mental health and substance use care, including initial and concurrent level‐of‐care decisions. Learn more
- InterQual® Technology Explore our interactive desktop, mobile, and cloud options for accessing InterQual® Technology and streamlining the medical review process. Learn more