Make Care Management Decisions Based on a Patient's Unique Presentation

InterQual® Behavioral Health Criteria empower care managers to make the most appropriate initial and ongoing level of care decisions based on each patient's individual presentation for:

  • Psychiatric conditions
  • Substance use
  • Dual diagnosis

Incorporating the expertise of a multidisciplinary panel of psychiatrists, psychologists, psychiatric nurses and social workers, InterQual Behavioral Health Criteria are available for:

  • Seniors
  • Adults
  • Adolescents
  • Children

The criteria encourage reviewers to consider the severity of symptoms or behaviors in the context of patient-specific variables that help place a patient in the most appropriate level of care. Standardized decision paths provide case managers, utilization reviewers and providers with a common language that enables consistent, objective decision-making.