InterQual® Utilization Management

With the InterQual® Utilization Management application, case and utilization managers, across hospitals and health plans have access to the latest evidence-based InterQual® Criteria and can efficiently conduct a medical necessity review where they want to, within their workflow. Hospitals who use InterQual® AutoReview can receive the automated review, with embedded EHR data, within the Health Cloud workflow; reducing administrative burden and allowing case managers to focus on managing and progressing patient care. To further drive efficiency and transparency, health plans can enable provider access via a portal on Experience Cloud, streamlining the prior authorization process by eliminating faxes, phone calls, and the need to conduct redundant reviews. ​ .