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InterQual criteria.Doc#: PCA-1--016652-06302021 v60.06.2021 2021 Care Provider Manual Physician, Health Care Professional, Facility and Ancillary MissouriThe ASAM Criteria Powered by InterQual ASAM has partnered with Change Healthcare to develop software for using The ASAM Criteria in utilization review and This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. 2021 Blue Cross modifications of InterQual acute care criteria . endstream
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The hierarchy of consideration for determining the level of care for Medical Services is as follows: A. SPD coverage exclusions or , https://uhealthplan.utah.edu/medicalpolicy/pdf/admin-002.pdf, Discovery benefits health savings account, Interqual behavioral health criteria manual, North central texas community health center, Maxim healthcare staffing pittsburgh pa, Allways health partners provider portal, Quantum health prior authorization form, 2021 health-improve.org. InterQual criteria developed using evidence-based rigor and peer review standards. VNA Home Care , https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/loc-bh, Health (3 days ago) InterQuals content has been updated to reflect the most recent evidence-based and clinical standards. Evidence-based clinical intelligence to support appropriate care 0 Evaluate the safest and most efficient level of care using objective and specific criteria 11/01/20 Annual Review, approved Oct. 13, 2020. 201 0 obj
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Proprietary benchmarks for Length of Stay and Percent Paid as Observation. Interqual criteria manual 2019 pdf. #kyksuM"f[! BCN 2019 Local Rules: Adult/Geriatric Residential Mental Health Treatment. InterQual criteria sets for acute adult, acute pediatric, inpatient rehabilitation and subacute skilled nursing facilities contain objective endpoints for service, allowing utilization review nurses to perform reviews of admission, discharge or transfer readiness with built-in checkpoints to identify progress, plateau or achievement of goals. Interqual guidelines for behavioral health, Interqual behavioral health criteria tool, Health (5 days ago) Evidence-based behavioral health criteria InterQual criteria developed using evidence-based rigor and peer review standards Proprietary benchmarks for Length of Stay and Percent Paid as Observation Care management information notes with InterQual guidelines for expected progress, care facilitation, and admission considerations, https://www.changehealthcare.com/clinical-decision-support/interqual/behavioral-health-criteria, Health (5 days ago) (5 days ago) Evidence-based behavioral health criteria InterQual criteria developed using evidence-based rigor and peer review standards Proprietary benchmarks for Length of Stay , https://www.health-improve.org/interqual-behavioral-health-criteria-manual/, Health (2 days ago) (6 days ago) WebInterQual Behavioral Health Criteria are a set of measurable, clinical indicators, as well as diagnostic and therapeutic services, that reflect a patient's need for , https://www.health-improve.org/interqual-criteria-for-behavioral-health/, Health (Just Now) InterQual criteria sets for acute adult, acute pediatric, inpatient rehabilitation and subacute skilled nursing facilities contain objective endpoints for service, allowing utilization review , https://www.priorityhealth.com/provider/manual/standards/utilization-management-program/interqual-loc-criteria, Health (7 days ago) InterQual Behavioral Health Criteria Description InterQual Child Psychiatry Criteria For the review of patients who are age 4 to 12 years. interqual-training-manual 2/3 Downloaded from coe.fsu.edu on January 14, 2023 by guest ci therapy training manuals & publications A customer service training manual serves as an Please try again. InterQual Criteria is evidence-based clinical decision support criteria developed by Change Healthcare, hbbd```b``A$SX$~&@$$XLb&& I`~0;D,~b;+H,H{ $, QNK
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interqual criteria pdf. inpatient admissions, residential treatment center admissions, outpatient visits. The criteria are updated continually and released annually.
These products help the reviewer determine the appropriateness of patient care across a , https://prod.cue4.com/help/InterQualOnline/AnonymousReviewHelp/content/about-criteria-products.htm, Health (Just Now) For all Medicare members, first identify relevant NCD or LCD Criteria. Use SHIFT+ENTER to open the menu (new window). WebInterqual criteria manual 2021 pdf. InterQual Acute Pediatric Criteria Help determine the appropriateness of admission, continued stay and discharge at acute care facilities for patients who are less than 18 years of age. hb```b``fe`e`0Wdd@ A(GC^ ,`q$ )L6H8807qp )#~
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Optimize your company's health plan. 1. Depending on the product you selected, you view criteria in either decision-tree format or question-and-answer (Q&A) format. See our high-quality Medicaid plans and understand your coverage. Obtain authorization prior to purchase or placement. Blue Cross implemented the adult and pediatric 2021 InterQual acute care criteria on Aug. 2, 2021. Please turn on JavaScript and try again. Beginning August 27, 2022, the Utilization Management department at Independence Blue Cross will use the 2022 InterQual Criteria for review of adult acute care, pediatric acute care, long-term acute care, acute rehabilitation, home care, outpatient rehabilitation, and selected inpatient procedures. Orthopedic footwear, custom Requests for orthotics will be reviewed on a case-by-case basis using related InterQual subset CP: Durable Medical Equipment Orthoses, Lower If the criteria are met, the case is approved; if the criteria are not met, the case is referred to the medical director. 0000004273 00000 n
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