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InterQual® Level of Care Criteria help healthcare organizations assess the safest and most clinically appropriate care level for more than 95% of reasons for admission. The condition-specific format presents evidence-based interventions that are specific to the condition and help to cost-effectively improve outcomes.
InterQual® Level of Care Criteria | Change Healthcare
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InterQual® - changehealthcare
InterQual Criteria InterQual Criteria are objective and specific to better help ensure the most appropriate care and more consistent, defensible decision-making. Our four criteria suites provide comprehensive coverage for medical and behavioral health across all levels of care as well as ambulatory care planning.Location: 3055 Lebanon Pike Ste 1000, Nashville, 37214, TNLogin · Interqual Level of Care Criteria · Criteria Powered by InterQual · Interqual Education
InterQual Criteria Inpatient Admission – medicare b code
Admission as an inpatient is guided by established admission criteria of medical Interqual criteria, used by the Care Management Department, is the official
InterQual® Level of Care Criteria | Change Healthcare
InterQual® Level of Care Criteria help healthcare organizations assess the safest and most clinically appropriate care level for more than 95% of reasons for admission. The condition-specific format presents evidence-based interventions that are specific to the condition and help to cost-effectively improve outcomes.Location: 3055 Lebanon Pike Ste 1000, Nashville, 37214, TN[PDF]
Criteria Summary - Provider Central
The InterQual Acute Criteria is a valuable tool for ensuring that members admitted to an acute facility receive the right care in the right setting. The product provides support for determining the appropriateness of admission, continued stay, and discharge for members receiving acute
InterQual Clinical Revisions - Johns Hopkins Hospital
InterQual® SIM plus Criteria - Care Planning. SIM plus™ is the InterQual Surgical and Invasive Monitoring (SIM) tool. It is a valuable component of a comprehensive surgical case review program, providing an objective demonstration that surgery and/or invasive procedures were performed for clinically sound, properly documented indications.
Change Healthcare Introduces InterQual 2019
May 13, 2019InterQual AutoReview can now provide a full admission review for more than 50 high-volume conditions. On average, 75% of the data needed for initial reviews can be automatically populated with data pulled from the EHR—significantly reducing time spent on manual entry.[PDF]
INTERQUAL Application and Training - Tenet Healthcare
1. Case Management reviewers must conduct an admission/initial review on the day of admission as soon as adequate clinical information is available to complete an accurate review, but within 24 hours of admission.[PDF]
Hospitalization Status Guidelines for Cellulitis
present to qualify for full admission: (must document at least ONE) IV Antibiotics AND ONE ANC < 500 Pending cultures ≤ 2 days T > 100.4 (per rectum) IVF > 125 cc/hr or > 100cc/hr and age > 65 AND ONE BUN / Cr > 20 Na > 150 NPO Active vomiting Unresponsive to antiemetics[PDF]
Medical Necessity & Charting Guidelines
InterQual Guidelines for InterQual Guidelines for Medical Necessity Utilized for Medicare patient Acute Care inpatient or Observation – – Severity of Illness (SI) – – Intensity of Service (IS) Used for Adult and Pediatric Services Offers Discharge Screens Criteria are specific for – [PDF]
Inpatient, Outpatient and Observation: Medicare Rules and
• “An inpatient admission is not covered when the care can be provided in a less intensive setting without significantly and [directly] threatening the patient's safety or health. • In many institutions there is no difference between the
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