Automate authorization within your existing workflow

Prior authorization requirements create a costly administrative burden for both payers and providers. And when payers and their network providers conduct medical reviews to determine medical necessity in separate systems, the result is a redundant, manual and expensive process. Get to value quicker and get help reducing costs by using existing IT tools and assets to automate authorization and medical review.

Integrated into payers’ care and utilization management applications and provider portals, InterQual Connect™ is the only solution that enables automated authorization and medical review within the context of payers’ and providers’ existing workflows.

InterQual Connect lets you access evidence-based 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. This easy-to-implement solution can help you save time and lower administrative costs while enabling you to improve payer/provider relations.

Leverage your existing technology

Do you currently use a care management program with clinical and business rules?
Do you have a provider portal?

InterQual Connect works within your existing care management systems and provider portals, providing the missing capability for full auto-authorization. There is no need to install new software.

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InterQual Connect helps:

  • Reduce manual authorizations and costs. Automate authorization requests, even those that require medical review, saving time and administrative costs for both you and your providers.
  • Improve payer/provider relationships. Streamline the utilization management process and automate notifications and authorizations, reducing admin costs and eliminating provider hassle. Consistent clinical guidelines and authorization automation will be deployed within the payer’s portal, hospital utilization management systems, and payer care management systems. This exchange of clinical guidelines and authorization information provides full transparency to you and your providers.
  • Align with providers on standards of care. Gain convenient access to the same evidence-based InterQual Criteria used by over 3,700 hospitals. Connect with providers already using InterQual in their care or utilization management system through our wide range of alliance partners and through CareEnhance® Review Manager.
  • Provide fast and secure connectivity. Exchange authorization communications with providers that include the completed medical review inside (278 plus the medical review), supporting automated authorization and/or notification using standard industry formats. InterQual Connect includes routing rules to control access to data, content rules to allow for different InterQual versions, and duplicate checking rules to ensure this request has not been sent before.