NASHVILLE, Tenn.--(BUSINESS WIRE)--Apr. 19, 2022-- Today, Change Healthcare (Nasdaq: CHNG) released InterQual® 2022, the latest edition of the company’s flagship clinical decision support solution for the delivery of the latest, evidence-based appropriate care. The release includes new criteria for emergent trends, restructured and interactive criteria to streamline workflows, and artificial intelligence (AI) to drive proactive insights and efficiency. All updates have been rigorously researched and independently peer reviewed, so users can feel confident that the criteria are free of bias.

The expansive suite of criteria features new additions and comprehensive content updates such as the inclusion of new American College of Cardiology and American Heart Association guidelines for the management of chest pain, expanded tools for transition planning and social determinants of health (SDOH) assessment for behavioral health patients, and a new content module (The ASAM Criteria® Powered by InterQual®) developed through an exclusive partnership with the American Society of Addiction Medicine (ASAM).

“Driscoll Health Plan’s Utilization Management department has relied on InterQual® Criteria for more than 20 years for objective and leading-edge clinical decision support. Our teams find it user-friendly, and with it being a cloud-based solution, new releases are instantly accessible with no IT lift. We look forward to what InterQual 2022 has to offer with its expanded and updated criteria and technology-enabled, simplified processes,” said Heather Pigott, RN, CCM, CMCN, senior director of utilization management at Driscoll Health Plan.
The release also incorporates streamlined workflows for health care providers and health plans alike. The new InterQual Decision Reasons add-on provides organizations easy access to content used to consistently and clearly communicate to patients why a service may not be clinically appropriate. With the addition of review-sharing functionality, providers can electronically share InterQual reviews with payers, eliminating manual authorization transactions. To further drive authorization efficiency, the InterQual Outpatient Rehabilitation and Chiropractic criteria have been restructured to streamline submissions. Lastly, auto-selection functionality added to Medicare Content Powered by InterQual® allows for national or local coverage determinations or Medicare administrative contractors to be automatically selected based on date and service location.

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