Hospitals and health plans rely on making good utilization management decisions based on evidence-based clinical guidelines. But solid clinical content is only the foundation of the infrastructure needed to help them meet today’s challenges.
What will your organization need to meet the evolving challenges? McKesson has the checklist covered.
❏The most broadly used clinical criteria. Numbers don’t lie. InterQual® is used by more than 4,100 hospitals and 300 payers. We were the first to recognize the need for evidence-based criteria to answer critical questions about the appropriateness of care and resource use, and our history reflects our commitment to innovation to help meet the changing needs of both providers and payers including a common language to drive better collaboration.
❏Auto-authorizations connected to network intelligence. Cloud-based clinical decision support software that automates medical review, authorization, notification and eligibility and uniquely offers immediate access to coverage, network rules, medical appropriateness and in-network service provider information.
❏Precise information on molecular diagnostics. The only online catalog for molecular diagnostic tests that provides specific test identification and the evidence to help make policy decisions in one easy-to-use workflow.
❏Easy-to-use complex care guidance. Manage the most complex of patients and help assure the right intervention to drive better healthcare outcomes with a blended assessment for patients that can be easily integrated into nearly any care management tool you use.
❏Integrated, flexible workflows. InterQual Criteria are fully integrated with more care and case management applications than any other criteria, enabling payers and providers to define their own workflows and help maximize efficiencies.
❏Reliable, consistent data from patient admission to claims payment. Our solutions encompass eligibility, medical necessity, pre-authorization and claims auditing to help reduce administrative inefficiencies. Keep every stakeholder aligned with a shared source of criteria throughout the continuum.
❏Mobile accessibility. Payers and providers can get on-the-go access to McKesson’s InterQual content on iOS® and Android™ devices, to help improve their medical decisions at the point of care and expedite their medical necessity administrative process.