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InterQual® Level of Care Criteria | Change Healthcare
InterQual® Level of Care Criteria help healthcare organizations assess the safest and most clinically appropriate care level for more than 95% of reasons for admission. The condition-specific format presents evidence-based interventions that are specific to the condition and help to
Evidence-Based Criteria/Guidelines | Utilization
InterQual Criteria. InterQual Criteria are objective and specific to better help ensure the most appropriate care and more consistent, defensible decision-making. Our four criteria suites provide comprehensive coverage for medical and behavioral health across all
Transition to Interqual Criteria - Healthcare News - BCBSND
Blue Cross Blue Shield of North Dakota (BCBSND) has made the decision to retire several of our current medical services policies and further our use of the InterQual criteria set. The change goes into effect June 5, 2018, for medical services and July 1, 2018, for behavioral health services. InterQual is a nationally recognized utilization []
Medical Necessity Guidelines: Home Health Care Services
PDF fileHealth Plan uses InterQual® criteria to determine medical necessity and to authorize home care services after the initial evaluation visit, or after six months of continuous services for Tufts Health
Medical Necessity & Charting Guidelines
PDF fileInterQual Guidelines for InterQual Guidelines for Medical Necessity Utilized for Medicare patient Acute Care inpatient or Observation – – Severity of Illness (SI) – – Intensity of Service (IS) Used for Adult and Pediatric Services Offers Discharge Screens Criteria are
Blue Cross 2019 InterQual criteria implemented
PDF fileInterQual home health care criteria Blue Cross will implement the 2019 InterQual home health care criteria on Aug. 1, 2019. On this date, the modifications outlined below will take effect, and all previous modifications and InterQual criteria will be replaced with these guidelines.
Medical Necessity Criteria Chart
PDF fileInterQual® criteria; Home Care Services State plan home care service requirements and criteria are listed in the Community-Based Services Manual Home Care Nursing requires authorization for MSHO, MSC+, MNCare plans Authorization required prior to first visit for Connect, Connect + Medicare and Connect Dual members. Follow DHS Community-Based
InterQual LOC criteria | Priority Health
InterQual ® LOC Home Care Services criteria; The InterQual ® criteria are used by the utilization review nurses when conducting inpatient and post-acute utilization review. InterQual ® criteria are clinically based on best practice, clinical data and medical literature. The criteria are updated continually and released annually.
‎InterQual Mobile on the App Store
InterQual® Mobile offers you around-the-clock access to the latest and most accurate clinical content at your fingertips. All app features are available for free. To access your InterQual content for use with InterQual Mobile, you will need to enter your InterQual Criteria licensing credentials.2.2/5(16)Category: Medical
Medical Necessity Guidelines: Behavioral Health Level of
PDF fileInterQual Criteria are nationally recognized medical necessity behavioral health criteria developed by a clinical research staff, which includes physicians, registered nurses, and other health care professionals. The clinical content of the criteria is annually reviewed, updated, and validated by a
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