InterQual SmartSheets provide a concise,convenient format of InterQual Criteriathat provides support at the point-of-care and facilitates communication between a provider and payer. You generate a SmartSheet as a PDF and then use the printed PDF to record review information that you fax or email to a payer.
Generating an InterQual® SmartSheet™
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Pre-Service Review: Transition to InterQual Criteria
How to Access InterQual® Criteria. The InterQual criteria is available to clinicians through SmartSheets TM on Wellmark. The SmartSheets are secure content, so you will need to log in to view. You will need to be assigned the Utilization Management Procedures & DME role to view the SmartSheets. Your designated security coordinator (DSC)..
Smartsheet: Work Different
Smartsheet: Work Different Work Different Move ideas to impact, fast, with the leading work execution platform built to plan, capture, manage, automate, and report on work - at scale.Log In · Pricing · About Us · Product Overview · Video Center · Why Smartsheet[PDF]
Medical Necessity Guidelines: Procedures for the Treatment
Note: Procedures for the Treatment of Symptomatic Varicose Veins Not Available from InterQual®: Stab Phlebectomy, please refer to the separate Medical Necessity Guidelines. To obtain prior authorization for procedure(s), choose appropriate InterQual SmartSheet(s) listed below.[PDF]
Authorization requirements by product - Provider Central
Authorization Requirements by Product (rev. 1/19) 5 of 8 Behavioral health authorization & notification requirements Please note: Authorization requirements listed do not always reflect a subscriber’s benefits. Always check eligibility and benefits prior to providing services.
Increase Your IQ Webinars - interquallearning
Using InterQual® SmartSheets in InterQual® Criteria Demonstration This 5 minute demo shows you how to use SmartSheets in InterQual® Cloud Solutions. This 5 minute demo shows how to access SmartSheets in InterQual Criteria.[PDF]
Free Download Here - pdfsdocuments2
Blue Cross Interqual Smart Sheets Free Download Here Note: We recommend the use of InterQual SmartSheets to submit authorization requests for certain services listed on pages that follow Blue Cross Blue Shield April 2009 Providerfocus - Massachusetts Health Insurance[PDF]
Medical Necessity Guidelines: Bone Growth Stimulators
In order to obtain prior authorization for this piece of durable medical equipment, an InterQual SmartSheet for Bone Growth Stimulator must be completed and faxed to the appropriate fax number listed above according to Plan. The following individual InterQual SmartSheets are to be used when requesting prior authorization:
Tufts Health Plan - Requirements For Bariatric Surgery
Mar 01, 2017Tufts’ Pre-Approval Requirements. The relevant InterQual®SmartSheet™ for bariatric surgery should be filled and faxed to the Tufts Health Plan Precertification Department. Members have to be at least 18 years old at the time of the surgery. Members have to complete the 6-month Tufts Health Plan Lifestyle Management Program.[PDF]
Interqual Manual 2018 - actualusa
InterQual SmartSheet be completed and faxed, with supporting documentation Section Manual; Section Policies; These include Interqual, A hospital's case managers or Utilization Management staff will review the patient's record, InterQual is the Gold Standard in [PDF]
What’s New: InterQual® 2015 & CareEnhance® Review
InterQual Procedures Criteria updates contain three new subsets for both pediatric and adult, including a new subset on Transcatheter Aortic Valve Replacement (TAVR), as well as 15 new clinical indications for existing surgical or invasive procedures.
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