InterQual® Ambulatory Care Planning Criteria
Evidence-based criteria for providers and payers who want to support appropriate use of imaging studies, procedures, tests, equipment, and specialty medications and referrals.
Support appropriate use by following clinical recommendations for DME, imaging, molecular diagnostics, procedures, specialty referrals, specialty Rx, and retrospective monitoring.
Support consistency by applying criteria prospectively or retrospectively to manage utilization and identify differences in practice patterns.
Streamline the review process with timely evidence-based guidance, extensive references, and an intuitive Q&A format presented within a single workflow, according to the clinical scenario.