Interqual Medical Policy

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InterQual Actionable Evidence-Based Criteria …

https://www.mckesson.com/documents/health-plans/interqual-criteria/

InterQual Procedures Criteria Are evidence-based medical necessity guidelines for nearly 300 high-volume, high-cost procedures. The criteria help make documenting medical necessity easy while helping to improve the quality of care. Covering major …

InterQual Criteria | Blue Cross Blue Shield of Massachusetts

https://www.bluecrossma.org/medical-policies/interqual-criteria

InterQual aligns payers and providers with actionable, evidence-based clinical intelligence to support appropriate care and foster optimal utilization of resources. …

Evidence-Based Criteria/Guidelines | Utilization …

https://www.changehealthcare.com/clinical-decision-support/interqual

Evidence-based InterQual Criteria to support appropriate care decisions. Make the safest, most efficient care decisions by using objective, specific criteria for both …

InterQual LOC criteria | Priority Health

https://www.priorityhealth.com/provider/manual/standards/utilization-management-program/interqual-loc-criteria

InterQual ® criteria sets for acute adult, acute pediatric, inpatient rehabilitation and subacute skilled nursing facilities contain objective endpoints for service, allowing …

Surgical Treatment for Spine Pain - UHCprovider.com

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/exchange/surgical-treatment-spine-pain-iex.pdf

InterQual® Technology | InterQual® | Change Healthcare

https://www.changehealthcare.com/clinical-decision-support/interqual/interqual-technology

InterQual Transparency is an integrated cloud-based solution that provides physicians and members with intuitive, reference-only access to the InterQual criteria within payers’ …

Sacroiliac Joint Interventions - UHCprovider.com

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/sacroiliac-joint-interventions.pdf

• Sacroiliac Joint infection when used as an adjunct to the medical treatment • As part of multisegment spinal constructs extending to the ilium • Painful degenerative joint disease …

Medical Policies | WPS

https://www.wpshealth.com/resources/provider-resources/medical-policies.shtml

These medical policies and MCG Health guidelines are intended to be used in conjunction with the independent professional medical judgment of a qualified health care provider. …

Medical policy | Providers | Independence Blue Cross (IBX)

https://www.ibx.com/resources/for-providers/policies-and-guidelines/operations-management/medical-policy

Medical policy. The Medical Policy Portal offers streamlined navigation to the various types of policies available. Once you accept the terms and conditions below, you’ll be …

What You Need to Know About the Utilization Review …

https://www.psqh.com/analysis/what-you-need-to-know-about-the-utilization-review-process/

Acute inpatient hospitals use Milliman and InterQual criteria to help determine the appropriateness of care. Both sets of criteria are evidence-based screening tools …

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