Streamline the medical review process with a variety of access options for using InterQual® Criteria. This medical review automation solution increases utilization management (UM) …

InterQual® Criteria – Industry-leading medical necessity criteria that supports payers and providers in the delivery of better, safer, lower-cost health care.

criteria to be met. This is called a selectable rule (or checkable rule) and occurs when both the criteria point at the same level as the rule and the underlying criteria

The online help provides a step-by-step guide for you to refer to as you use the application to work with InterQual Criteria. It also includes job aids and video tutorials.

Sep 9, 2025 · InterQual® criteria are a first-level screening tool to assist in determining if the proposed services are clinically indicated and provided in the appropriate level or whether …

InterQual Customize is a content creation and editing solution that lets you author your own care management guidelines or customize existing InterQual Criteria to meet your organization’s …

If you're considering a career pivot in the remote nursing world, read this guide to MCG and InterQual, two essentials for remote nursing jobs.

Aug 18, 2025 · This criteria line was updated to clarify the intent, capture newborns with drug withdrawal after opioid exposure, and ensure the symptoms being adequately managed by the …

When we receive a request for authorization or prior approval, our utilization review nurses use Change Healthcare’s InterQual® criteria to determine if the services and level of care are …

When we receive a request for authorization or prior approval, our utilization review clinicians use InterQual® criteria to determine if the services and level of care are clinically indicated.