Livanta Selects InterQual To Support Its Medicare Utilization And Quality Care Reviews

Livanta Selects InterQual to Support its Medicare Utilization and Quality Care Reviews

  • January 28, 2016

Today we announced that healthcare services company Livanta licensed InterQual after becoming the Beneficiary and Family-Centered Care Quality Improvement Organization (BFCC-QIO) for Centers for Medicare & Medicaid Services (CMS) Areas 1 and 5. Livanta signed a long-term agreement to use InterQual for utilization and quality reviews for Medicare beneficiaries, including short-stay inpatient status claims reviews. Livanta is one of only two BFCC-QIOs charged by CMS to audit short-stay claims. Read the news release

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Three Must-Dos For Payers, Providers Seeking Successful Collaboration

Three Must-Dos for Payers, Providers Seeking Successful Collaboration

  • August 14, 2014

“The only way to win is to work together,” advises Holly Toomey, RN, BS, HCA, director, product management at McKesson Health Solutions. Her recent blog post features practical advice for payers and providers navigating the new reality of healthcare: success requires the best possible clinical outcomes at the lowest possible costs. To build a more comprehensive, collaborative relationship between payers and providers, Toomey suggests: An Automated Utilization Management Process – Use electronic tools to streamline requests for treatment, minimizing patient delays and making it easier to exchange clinical and financial information in real time. A Shared Exception-Based Utilization Management System - Set…

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Can Utilization Management Work In A Value-Based World?

Can Utilization Management Work in a Value-Based World?

  • August 5, 2014

Beauty is in the eye of the beholder. And solutions to healthcare’s problems are in the eye of the stakeholder. Payers see the world one way, providers another, and patients still another. Finding solutions that balance stakeholders’ concerns isn’t easy. But it’s not impossible, if you bring the varying points of view together. I've been privileged to work with all stakeholders—payers, providers, and patients—and have heard (and hear) their problems, anxieties, and concerns. It’s from this vantage point that I've been wrestling with the problem of utilization management in a world that’s moving rapidly to value-based models. Today, prior authorization…

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