Put Prior-Auth On The Fast-Track

Put Prior-Auth on the Fast-Track

  • December 15, 2016

Everyone who thinks prior-authorization is a fast, efficient process, please raise your hand. No raised hands? No surprise. That’s because the prior auth process has been on the slow track for years, powered by paper, faxing, siloed software, and phone calls. Now payers can give provider networks a fast-track option for prior auth, where getting an authorization is as easy as requesting it through the payer’s care management portal. Payers like it because it reduces costs by freeing staff to tackle other things. Providers like it because it helps speed quality care. In fact, the only people who don’t like…

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InterQual Connect A Fierce Innovation Awards Finalist

InterQual Connect a Fierce Innovation Awards Finalist

  • October 7, 2016

Today, the editors of FierceHealthcare, FierceHealthIT, and FierceHealthPayer named McKesson’s InterQual Connect as a Fierce Innovation Award 2016 finalist in the Clinical Information Management Innovation category.The award recognizes technologies, tools and programs that are driving improvements and transforming the healthcare industry. Read the news release

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Short-Stay Inpatient Rate Is Zero? Time For Documentation Improvement

Short-Stay Inpatient Rate is Zero? Time for Documentation Improvement

  • May 11, 2016

Hospitals will need to reevaluate their documentation improvement programs because of revisions to the two-midnight rule, which allow for a case by case review of less-than-two-midnight stays. The quality improvement organizations have stated that the review will include InterQual screening criteria. Read the article

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Update Released For InterQual Tool

Update Released for InterQual Tool

  • April 18, 2016

Care managers determining length of stay and managing care transitions will benefit from the newly released InterQual 2016. The updates will help case managers support discharge planning, better manage care timelines, conduct timely interventions, reduce avoidable days, and improve bed management. Read the article

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McKesson And KEPRO To Share Guidance For Understanding The Two-Midnight Rule And Avoiding Denials At 2016 ACMA National Conference

McKesson and KEPRO to Share Guidance for Understanding the Two-Midnight Rule and Avoiding Denials at 2016 ACMA National Conference

  • March 29, 2016

Executives from McKesson Health Solutions and KEPRO will come together at the ACMA 2016 National Conference in Tampa, Florida, to help providers make sense of the Two-Midnight Rule as well as how to reduce denials. The interactive session, scheduled for April 5th, is a unique opportunity to hear perspectives directly from one of only two BFCC-QIOs charged by the Centers for Medicare & Medicaid Services to audit short-stay claims. Read the news release

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McKesson Unveils Cloud-based Ecosystem For Medical Review & Authorization

McKesson Unveils Cloud-based Ecosystem for Medical Review & Authorization

  • March 15, 2016

HIT Consultant reported on McKesson's launch of InterQual Connect, a cloud-based medical review service with automated authorization and connectivity for payers and providers. InterQual Connect works with the same care management systems and InterQual Criteria payers and providers already use, making it fast, easy, and cost-effective to implement and deploy. Read the article

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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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