What was the "top story" at HIMSS17? McKesson Health Solutions' preview of InterQual AutoReview. Developed in partnership with the National Decision Support Company, InterQual AutoReview automates medical necessity reviews by directly accessing patient data from EHRs. This breakthrough integrates NDSC’s platform into InterQual’s technology, decision support engine, and evidence-based content to streamline medical reviews at the point of care. Read the article
It's time to bring utilization management into the 21st century. A more collaborative, automated UM model could create a bridge between the current system, where authorizations happen after care decisions, and real-time communication between payers and providers that provides immediate decisions at the point of care. That bridge is what we call an "exception-based utilization management model." New technology can help payers identify which providers are getting approvals, for which care events, and how often. Then, using that knowledge, most care events can be automatically authorized, letting the payer limit their focus to the outliers. And even then, many of those…
There's tremendous pressure on hospitals to reduce denial rates, and the problem is getting worse as claims processing becomes more complex. One way to reduce denials is to close common gaps that lead to medical necessity denials, which can account for as much as 5% of denials. CMSA Today shares a ten step process to that can have a quick and positive impact on your revenue cycle. Read the article
Today McKesson announced its InterQual Coordinated Care Content has received new accreditation and vendor certification from URAC for achieving recognized standards in Case Management and Disease Management. McKesson Health Solutions also earned a three-year renewal reaccrediting CareEnhance Review Manager for Utilization Management (UM). The accreditations mark 13 years of continuous recognition by URAC, a leader in quality standards for the healthcare industry.
McKesson has announced that InterQual Criteria is now accessible through new cloud-based implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. The cloud access makes it easier to use the evidence-based decision making criteria—including Level of Care, Planning, and Behavioral Health criteria.
Mckesson’s InterQual Criteria can now be accessed on the cloud, making it easier and faster for customers to access objective, evidence-based medical and behavioral health clinical content. The criteria will be available through cloud-based implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. The secure, fast cloud access will help providers make appropriate care decisions across the medical and behavioral health levels of care.
Today we announced that InterQual Criteria is now accessible as an on demand service. Customers can access InterQual’s evidence-based clinical decision support through cloud-based implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. This fast and easy access will help improve clinical decision-making and management for medical and behavioral health care.
McKesson announced that InterQual Criteria can now be accessed via cloud implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. What began over 40 years ago as thick printed books that users had to page through is now accessible on a variety of applications and platforms, from PCs to mobile devices to connected automated services and now, the cloud.
The Centers for Medicare & Medicaid Services (CMS) will continue their contract with McKesson Health Solution's InterQual Criteria for Medicare services auditing programs. CMS relies on InterQual's evidence-based clinical decision support to help better manage patients as the industry transitions to value-based care. Read the article