Solution
InterQual® Behavioral Health Criteria
Evidence-based clinical decision support for payers and providers who want to make the most appropriate care decisions for mental health and substance use.
Evidence-basedcriteria to support behavioral health decisions
Continuum and Q&A formats to provide timeline guidance
Help move patients safely and efficiently through the continuum of care by presenting all settings of care in one view, which incorporates the episode day/week for level-of-care decisions. Intuitive Q&A format simplifies appropriateness decisions for behavioral health services.
Comprehensive content to consider the whole patient
Determine the appropriate level of care or service by factoring in symptoms, comorbidities, functional status, SDoH risk factors, support-system quality, and more. The solution recommends lower levels of care when the patient is improving and more intense settings when the patient’s condition is deteriorating.
Development process to support mental health parity
Help address mental health parity by using InterQual criteria that are developed using the same evidence-based rigor we apply to—and are not more stringent than—our medical/surgical criteria.
Industry content powered by InterQual to drive consistent, efficient reviews
Streamline your medical review process by giving users easy access to The ASAM Criteria® and Medicare policies that have been converted into a structured, interactive tool.
What’s included in InterQual Criteria for Behavioral Health
PRODUCT SUPPORT
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