Today we announced that KEPRO (Keystone Peer Review Organization, Inc.) will continue its use of InterQual for utilization and quality reviews. KEPRO is one of only two Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIOs) charged by the Centers for Medicare & Medicaid Services (CMS) to audit short-stay claims. As part of the new long-term agreement, KEPRO will use InterQual for review of two-midnight short stays on behalf of CMS, in addition to quality reviews for its state Medicaid contracts and commercial lines. Read the news release
Today we announced that eQHealth Solutions has signed a long-term agreement to continue its use of InterQual and CareEnhance Review Manager. eQHealth will use the InterQual evidence-based clinical criteria for its four state Medicaid contacts in addition to its other commercial lines.
Radiology and diagnostic imaging news site AuntMinnie.com covered our recent customer news. We announced that eQHealth will use InterQual evidence-based clinical criteria for its state Medicaid contracts in Florida, Illinois, Mississippi, and Colorado, in addition to its other commercial lines. Read the full story
Here's some news we know payers will be excited about. Today we pulled the wraps off of Reimbursement Manager 3.0, the first next-generation pricing tool for health plans. This innovative new technology automates complex network pricing strategies to allow value-based reimbursement to scale, by giving health plans the ability to build and manage complex mixed-model rate schedules efficiently. Read the press release
Healthcare Payer News just covered our announcement introducing the ground-breaking Reimbursement Manager 3.0. They zeroed in on McKesson’s innovative approach to automating complex network pricing, and how this can help health plans address the challenges inherent in transitioning to mixed reimbursement models. Read the article
Our announcement of Reimbursement Manager 3.0 grabbed the attention at Healthcare Finance News. HFN reports that the new tool offered by McKesson Health Solutions can play a key role in helping health plans manage mixed payment scenarios as they transition from fee-for-service to value-based reimbursement. Read the article
Today we announced that nearly 500 payers and providers purchased or renewed InterQual®, our flagship evidence-based clinical decision support solution, and related decision management solutions in the first six months of the year. Read the release for the full story.
Today we opened the 28th annual McKesson Health Solutions Conference, where over 300 healthcare professionals from leading payers and providers come together for a week of networking, learning, and focusing on a better future for healthcare. This year MHSC takes place at the Aria Resort in Las Vegas. McKesson executives and customers will discuss key industry issues and share ideas, experiences, and best practices for simplifying and transforming reimbursement with the new healthcare consumer in mind. Next year MHSC arrives in Orlando, Fla. If you'd like to attend, set a bookmark to the MHS Conference event page, and keep an…
Today we announced that the Centers for Medicare & Medicaid Services (CMS) renewed its agreement to use InterQual® Criteria for its Medicare services auditing programs, an extension of a 15-year relationship. The CMS departments are using the InterQual 2015 release to to help ensure payers and providers have the most current, best evidence for improved decisions across the continuum of care. Read the news release
Today RelayHealth Financial introduced ICD10Central.com – the last site that providers will need for the last mile of their ICD-10 journey. With a real-time ICD-10 KPI dashboard, expert coding guidance, payer-supplied resources, and peer-powered best practices, the site offers a wealth of information to help providers prevail during these final hectic days. Read the news release