Provide the most appropriate high-quality care

All payers and providers want to deliver the highest quality, most appropriate care while eliminating waste. InterQual® Criteria helps you get better patient outcomes with evidence‐based, clinical decision support.

InterQual’s comprehensive portfolio includes five content suites:

  • InterQual Level of Care Criteria Assess the safest and most efficient care level based on severity of illness, comorbidities and complications, and the intensity of services being delivered. Our criteria cover more than 95% of admission reasons for any level of care.
  • InterQual Behavioral Health Criteria Manage the delivery of mental health and substance use care, including initial and concurrent level‐of‐care decisions.
  • InterQual Care Planning Criteria Identify when imaging studies, procedures, DME, MDx tests, specialty pharmacy medications and specialty referral consultations are appropriate.
  • Content Powered by InterQual Content from CMS and others is converted into our easy-to-use Q&A format to support consistent application of third-party content to improve review workflow and efficiency.
  • InterQual Coordinated Care Content Generate a patient‐specific care plan for complex cases and high‐risk members with our patented blended assessment.

InterQual Criteria connects and aligns payers, providers and other organizations with actionable, evidence‐based clinical intelligence that helps optimize care management decisions, support the appropriateness of care, manage medical costs and foster appropriate utilization of resources. With our InterQual Content Customization Tool you can incorporate custom content based on organizational policies.

Clinical Integrity

The expertise and intense rigor we apply in the InterQual development process results in unparalleled content integrity, so you can have greater confidence in your clinical decision‐making.

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Innovative Technology

Our technology solutions include a broad range of options for accessing and applying InterQual Criteria within your workflow.

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Service Excellence

Our dedicated team of clinical experts provides implementation, education and consulting services to help you make the most of your InterQual investment.

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