BCBS INTERQUAL SHEETS
Pre-Service Review: Transition to InterQual Criteria
The Wellmark Authorization table will be updated accordingly to reflect these changes. The 2018 InterQual ® Criteria for all services requiring prior approval will be effective for any requests initiated on or after 10/13/18 regardless of date of service.
InterQual Criteria & SmartSheets - Blue Cross Blue Shield
InterQual Criteria and SmartSheets. Then scroll down to InterQual Level of Care Criteria. SmartSheets. We encourage Blue Cross Blue Shield of Massachusetts-participating providers to use Change Healthcare’s InterQual SmartSheets to submit prior authorization requests for certain procedures.
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Medical - Blue Cross Blue Shield of Massachusetts
Learn the clinical criteria we use to make medical necessity determinations for coverage of these medical and surgical services rendered to our members. Learn about InterQual & SmartSheets. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of
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Preauthorization and Utilization Management | bcbsm
Blue Cross Blue Shield of Michigan uses the following precertification, and preauthorization programs to ensure that our network doctors and hospitals provide the most appropriate and cost-effective care. Clinical necessity and criteria help identify cases that may benefit from the assistance of one of our preauthorization programs.
Medical Necessity Guidelines: Procedures for the Treatment
PDF fileInterQual criteria, sclerotherapy varicose vein, added for Varithena coverage BACKGROUND, PRODUCT AND DISCLAIMER INFORMATION Medical Necessity Guidelines are developed to determine coverage for benefits, and are published to provide a better understanding of the basis upon which coverage decisions are made.
Evidence-Based Criteria/Guidelines | Utilization
InterQual aligns payers and providers with actionable, evidence-based clinical intelligence to support appropriate care and foster optimal utilization of resources. The foundation of the InterQual solution is our market-leading clinical Criteria, which helps payers and providers consistently apply evidence-based clinical decision support.
InterQual ConnectTM Enhancing Enable automation of
PDF fileInterQual Medical Review & Authorization InterQual Connect is a flexible SaaS • solution, integrated into payer and provider health information systems. It pairs the leading InterQual® Criteria, now available as a web service, with proven and secure connectivity. • A unique solution: The