Automate authorization and help reduce administrative costs

Provide your members the right care at the right time in the right place without incurring costs for unnecessary care or administrative waste.

The cost of an inefficient process

Under the traditional approach to utilization management, providers must seek prior approval from payers for certain care. The burden of prior authorizations can lead to delayed or inappropriate care and create avoidable cost. In fact, 90% of pre-authorizations require manual, time-intensive intervention often resulting in $50-$100 payer and provider costs per authorization, and these manual medical reviews can take 3-4 days or more¹. According to the American Medical Association a majority of physicians surveyed reported that eliminating authorization hassles was “very important” (78%) or “important” (17%)².

Innovative technology solutions

InterQual Connect. The only solution that automates the medical review and enables automated authorization within the context of payers' and providers' existing workflows. Access InterQual® Criteria and leverage McKesson's fast, secure cloud connectivity/data exchange functionality to send the medical review and clinical information needed for full auto-authorization.

Clear Coverage. Automate authorization and coverage decisions in real-time. Clear Coverage is a cloud-based application and platform that incorporates InterQual Criteria and a health plan's custom criteria and business rules into its fully automated, interactive workflow to help streamline medical review, benefit and eligibility verification, and network steerage.

¹McKinsey & Company, Preauthorization Sizing (proprietary McKesson report), 2008.

²American Medical Association. “AMA Survey of Physicians on Preauthorization Requirements,” May 2010.