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McKesson Adds InterQual Procedures Criteria to Auto Authorization SolutionAugust 06, 2009 |
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Clinical Guidelines for Top 50 Procedures Now Available in Clear Coverage for Real-time Authorizations McKesson today announced that InterQual® Criteria for over 50 high-volume, high-cost outpatient procedures are now accessible through Clear Coverage™, the Company’s new automated authorization solution. The addition of InterQual clinical guidelines for procedures to Clear Coverage allows medical appropriateness to be determined automatically for most pre-authorization requests at the point of care, facilitating optimal care decisions as well as dramatic reductions in administrative costs for both payors and providers. InterQual Procedures Criteria, including criteria for bariatric surgery, cervical and lumbar spine procedures, and ankle, hip and shoulder arthroscopies, join InterQual Imaging and Molecular Diagnostics Criteria sets already available in Clear Coverage. Clear Coverage automates authorizations with real-time eligibility checks and medical appropriateness reviews. The solution also provides tools to guide real-time test or procedure selection and coverage decisions, and communicates network rules and estimated payments. “Leveraging McKesson’s innovative technology and InterQual clinical guidelines, we are building a solution that focuses on managing outcomes as well as medical and administrative costs across the care spectrum,” said Tammie Phillips, vice president of InterQual for McKesson Health Solutions. “Speeding medical necessity and authorization processes for the most common high-cost procedures moves us closer to that goal.” Used by over 4,000 healthcare stakeholders including hospitals, health plans and government agencies, InterQual is the most widely used evidence-based clinical decision support solution for healthcare utilization management. Clear Coverage is among the flagship offerings of McKesson’s Advanced Diagnostic Management solutions, which connect payors, providers and diagnostic facilities to support selection, performance and reimbursement of the right diagnostic at the right time for the right cost. More background on this announcement and McKesson’s Advanced Diagnostics Management solution is available in an online press kit at www.mckesson.com/diagnosticsnews About McKesson McKesson Corporation, currently ranked 15th on the FORTUNE 500, is a healthcare services and information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining processes, and improving the quality and safety of patient care. McKesson has been in continuous operation for more than 175 years, making it the longest-operating company in healthcare today. Over the course of its history, McKesson has grown by providing pharmaceutical and medical-surgical supply management across the spectrum of care; healthcare information technology for hospitals, physicians, homecare and payors; hospital and retail pharmacy automation; and services for manufacturers and payors designed to improve outcomes for patients. For more information, visit us at www.mckesson.com .
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McKesson Health Solutions
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