Bring Greater Automation and Accuracy to the InterQual Review Process
CareEnhance® Review Manager Enterprise (Review Manager) puts the power of InterQual® Criteria, the industry leader in evidence-based clinical decision support, at your fingertips. Review Manager is a browser-based, interactive product that helps automate and streamline the care review process and enables data retrieval and aggregated reporting.
With Review Manager, organizations can electronically share medical necessity reviews, which helps hospitals and health plans interact with each other in real time while supporting automation of inpatient authorizations. You can send and receive reviews between Review Manager systems within your organization or between Review Manager and Clear Coverage™, a clinical and financial decision support software-as-a-service solution that brings automated authorizations and coverage information to the point of care.
Review Manager’s reporting capabilities help you get the most out of your software and data. Reports give you insight into productivity and utilization management outcomes, helping you identify and improve practice patterns.
Review Manager is delivered two ways: locally installed or McKesson hosted. You can also use it as a standalone solution, or when locally installed, it can be integrated with other applications, such as McKesson VITAL Care Management solutions or other care management workflow applications. When integrated, Review Manager enables access to InterQual review information from within other applications, so you can easily put that information to work.
Review Manager helps:
- Increase consistency. Because you’re using automated workflows that rely on world-class InterQual Criteria, you can achieve greater consistency from reviewer to reviewer.
- Get you up to speed quickly and easily. Intuitive screen displays, a Q&A, nested decision trees format and printable criteria sets make Review Manager easy to use.
- Improve business practices. The ability to collect and organize data helps you identify trends, meet regulatory requirements, explore reasons behind utilization patterns and identify areas for quality improvement.
- Enhance efficiency. Features such as worklists, search capabilities and workflow options enhance productivity.
- Streamline administrative processes. By enabling efficient communication of patient reviews between organizations, Review Manager simplifies administrative processes while supporting a collaborative approach to patient care.
To work in conjunction with Review Manager, we offer the following:
- CareEnhance Review Manager Enterprise Plus Pak. Enhanced workflow supports management of both discharge planning and denials based on medical necessity. This add-on solution encourages proactive care, reduces paperwork, and identifies dollars recovered and areas for improvement that can affect the bottom line.
- CareEnhance® Review Manager Enterprise Integration Toolkit. This solution enables partners to integrate Review Manager with their care management applications.
- InterQual Transparency Solution. You can put your licensed criteria on a portal for providers to view, helping boost consistency in decision-making.
- InterQual Online Anonymous Review. This McKesson-hosted system lets you perform an interactive review with the gold standard InterQual® Criteria without specifying patient data, then transfer the results into another application, so a review can be processed without revealing PHI.
- InterQual Historical Criteria. This solutions helps you assess the appropriateness of care for audited claims using criteria in effect at the time of service.
Additional Decision Support Options
Health care organizations looking for more basic electronic access to their InterQual criteria sets can choose from the following:
- InterQual View, which gives read-only access to a desktop copy of licensed criteria
- InterQual Online, which gives read-only Internet access to licensed criteria