Criteria points are clinical statements that refer to test results, medications, symptoms, findings, monitoring, medical management, functional status. Joining mckesson health solutions in 1995, she initially served as vice president of clinical services for interqual and later as chief operating officer and general manager of the care management products division. To access your interqual content for use with interqual mobile, you will need to enter your interqual criteria licensing credentials. Tufts health plan requires the use of an interqual smartsheet to obtain prior authorization for select inpatient and outpatient surgeries and procedures and select durable medical equipment.
The my interqual library screen lists the books that have been downloaded from mckesson to your device. Covid19 coronavirus independence is committed to serving people who rely on us, especially when a significant health risk may be present. Stay connected to mps customer support afterhours or during peak call periods. Interqual evidencebased criteria portfolio enabling shared. Please see the specific medical necessity guidelines for these services, available in the provider resource center on the tufts health plan website. Access mckesson health solutions mhs customer hub using internet explorer at. Get information on mckesson pharmacy systems products and services. Case managers, find ces today through ccmcs pace course offerings. To the right of the book s you wish to download, tap download.
The conditionspecific format presents evidencebased interventions that are specific to the condition and help to costeffectively improve outcomes. Complimentary clinical training and education with mckesson academy, you get access to. Interqual level care criteria skip to main search results department. Apply to care manager, registered nurse manager, registered nurse case manager and more. Mckesson reports q4, fullyear results by antoinette alexander 05242018. How do i print an assessment showing questions, correct answers, and rationales. Interqual guidelines to determine medical necessity.
Page 1 complimentary clinical training and education with mckesson academy, you get access to. The full list of medical policies and clinical utilization management um guidelines are publicly available on the medical policy and clinical um guideline subsidiary website. Our observation unit is 212 years old, and we are on our third interqual book. You must provide the answer to your security question to complete the. Mckesson brings interqual criteria to the cloud youtube. Interqual criteria help payers and providers help ensure appropriate care across the medical and behavioral health continuums of care, which helps improve quality and reduce unnecessary cost. Download adobe acrobat reader to open and read pdf documents from this site. Interqual evidencebased clinical content as appropriate. Video training the following webbased, video training for the irr tools is provided for use by change healthcare to its customers.
I am pleased to introduce this publication and i am especially pleased with the work of the cmi committee members who have been meeting regularly, despite their busy work schedules and differing time zone challenges in order to deliver such guidelines. Mckesson brings interqual criteria to the cloud business wire. This tool is designed to complement, not replace, the healthcare professionals clinical judgment in providing care at the most appropriate level. The fy 2014 abc quality assessment and performance improvement program work plan outlines activities and initiatives targeted for the next fiscal yearbased on results from fy. Product support if you experience difficulties downloading the interqual mobile application, getting your interqual. Interquals comprehensive portfolio includes five content suites. Search results for mckesson and mckesson brand mckesson. Jan 17, 2017 impossible foods serves up impossible pork made from plants and impossible sausage made from. Interqual aligns payers and providers with actionable, evidencebased clinical intelligence to support appropriate care and foster optimal utilization of resources. Mckesson is the oldest and largest healthcare company in the nation, serving more than 50% of u. Criteria points are clinical statements that refer to test results, medications, symptoms, findings, monitoring, medical management, functional status, and prescribed therapies. News flash the revised fact sheet titled sole community.
Interqual content is the most widely used, evidencebased clinical decision support for care management because of its sound clinical logic, which rests on a rigorous, comprehensive development cycle. Interqual mobile offers you aroundtheclock access to the latest and most accurate clinical content at your fingertips. If interqual does not cover a behavioral health service. The criteria are developed using the same stringent, evidencebased clinical development process that the industry has come to expect from interqual.
Mckesson interqual level of care criteria 20 mckesson on. Interqual acute criteria acute adult criteria innovating. Interqual care planning criteria interqual care planning criteria help to identify when imaging studies, procedures, molecular diagnostics, durable medical equipment, specialty referral consultations and specialty pharmaceuticals are medically appropriate based on the evidence. For any assessment test, in order to enter the report center and print it so that you can see each question, its correct answer, and its rationale explanation, there must be. Interqual level of care criteria, interqual behavioral health criteria, interqual. Clinical and service system priorities have been identified in partnership with providers, members, and other key system stakeholders. Product support if you experience difficulties downloading the. Kaiser permanente revised milliman guidelines nicu levels. Mckesson interqual is an evidencebased clinical criteria that provides support covering medical and behavioral health across all levels of care as well as care planning and complex care management. Interqual level of care criteria 2012, acute care adult.
Mckesson interqual level of care criteria 20 ringbound january 1, 1900 by mckesson author see all formats and editions hide other formats and editions. Ham, md, a hospitalist who directs the adult medical observation unit at the university of michigan in ann arbor. This, in addition to our enhanced delivery options, enables more automated and intelligent solutions to fit the varied needs of our customers ultimately driving more efficient use of healthcare resources. The military health system selects mckessons interqual. Mckesson reports q4, fullyear results drug store news. This product is available to all interqual licensed organizations free of charge. Refined and proven over 30 years, this development cycle combines systematic, critical assessment of the medical literature by highly trained. And with the 2017 release, interqual is now fully and exclusively a digital clinical decision support platform, available on desktop pc, mobile devices, ondemand in the cloud, and integrated into. Business wire mckesson has released the 2012 update of its interqual clinical criteria and software, marketleading solutions that help payers and providers determine the.
We are closely monitoring the outbreak of covid19 and will publish resources to assist you in providing care to our members, your patients. Medical policies and clinical utilization management. Interqual guidelines to determine medical necessity summary effective april 1, 2017, anthem blue cross and blue shield medicaid anthem will begin utilizing interqual guidelines for medical necessity criteria. If you are a new user enter your email address below and well send you an email with instructions to login along with an initial password. We deliver onethird of all medications used daily in north america with operations in more than 16 countries.
The american society of addiction medicine will be used for substance use. Interqual behavioral health criteria are a set of measurable, clinical indicators, as well as diagnostic and therapeutic services, that reflect a patients need for hospitalization. Interqual evidencebased criteria portfolio enabling shared, clinical decision support mckessons interqual criteria portfolio helps support better patient outcomes through integrated, streamlined care management processes and evidencebased appropriateness of care decision support. During that time, she evolved the product strategy, accelerated sales and developed infrastructure to support clients and operations. Mckesson interqual criteria update mckesson interqual updates their clinical criteria manual annually. Kaiser permanente revised milliman guidelines nicu levels neonatal intensive care unit level iv if the following conditionsprocedures exist, in addition to the fulfillment of level iii criteria, the approved inpatient days should be assigned at level iv. Refined and proven over 30 years, this development cycle combines systematic, critical. Important updates updated mckesson interqual criteria.
Interqual evidencebased criteria portfolio enabling. The interqual content portfolio consists of four content. Mckessons interqual criteria, the standard for evidencebased clinical decision support, is now accessible on demand through a new cloudbased implementation. January 28, 2016 the military health system has signed an agreement for its military treatment facilities mtfs to use interqual, an evidencebased clinical decision support tool. The military health system selects mckessons interqual for. This communication is to inform you that blue cross and blue shield of minnesota blue cross will begin using the 2017 version of interqual on july 14, 2017. Product news, webinar recordings, technical documents, and more. The foundation of the interqual solution is our marketleading clinical criteria, which helps payers and providers consistently apply evidencebased clinical decision support. The theme for this years conference is moving ahead. The medical supply ordering process can be tedious and timeconsuming, taking up valuable minutes that could be spent managing your business and caring for patients. Price new from used from ringbound, january 1, 1900 please retry. Mckesson advanced diagnostics management dark daily. Access your interqual criteria on your tablet or smartphone with a few swipes of your finger.
To navigate through the ribbon, use standard browser navigation keys. The design of mckesson s interqual acute criteria helps payers and providers get past these barriers and address their critical needs. This article was updated on july 31, 2012, to reflect current web addresses. This theme is intended to acknowledge all of the activity that is taking place, while emphasizing the need to continue the planning, coordination, and collaboration it takes to sustain meaningful system change. Interqual level of care criteria change healthcare. Nurses will retain half the seats on nmcs governing council. Guidance on hospital inpatient admission decisions note.
Submit and track service requests at your convenience 247. Medical policies and clinical utilization management guidelines attached is a list of the clinical um guidelines andor medical policies the health plan has adopted. Leveraging knowledge and action to improve health care quality. Mckesson brings interqual criteria to the cloud business. Easily search and find preapproved ce courses that will help you maintain your ccm. Kaiser permanente revised milliman guidelines nicu. If you cannot remember your password and failed logging in too many times, enter your user name below and well email you a link to provide a new password. This estimate is based upon 2 mckesson outcomes researcher salary reports provided by employees or estimated based upon statistical methods. Medical policies and clinical utilization management guidelines.
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