Mckesson interqual level of care criteria book

This new criteria allows for appropriate admission of medically complex. Interqual acute criteria provide the structure for proactive, effective care management in a valuebased world. Medical necessity ucare jan 25, 2018 cms benefits policy manual inpatient service section. Access articles, resource guides, webinars and more to learn about todays key clinical topics. Hello, i am a case manager at an acute care hospital where i am also in charge of managing pcu downgrades. Nicu, special care, newborn, and transitional care.

Interqual criteria downgrades case management allnurses. Mckesson s interqual content portfolio helps support better patient outcomes through integrated, streamlined care management processes and evidencebased appropriateness of care decision support. To view and print interqual criteria, you use book view. Impossible foods serves up impossible pork made from plants and impossible sausage made from. Interqual mobile, the first mobile version of mckessons interqual content, is now available at no additional cost. Interqual evidencebased criteria portfolio enabling. Review the criteria for the next steps of intensive treatment options. Community health solutions makes the most of every healthcare dollar december 03, 2014 community health solutions of america chs is a nationally recognized provider of innovative and comprehensive medical care management services for a diverse client base serving more than 200,000 covered lives. Interqual level and related national uniform billing nub revenue code based on the. The interqual content portfolio consists of four content suites.

Priority health chose interqual loc criteria based on requests from providers and because all of our contracted care facilities use interqual loc criteria. Mckesson clinical resources mckesson medicalsurgical. Interqual home health care criteria blue cross will implement the 2019 interqual home health care criteria on aug. 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 foundation of the interqual solution is our marketleading clinical criteria, which helps payers and providers consistently apply evidencebased clinical decision support. Interqual level of care criteria interqual care planning criteria. Blue cross blue shield of massachusetts is an independent licensee of the blue cross and blue shield association. Book depository books with free delivery worldwide. Beyond addressing specific disease states, care management can also encompass a variety of other clinical practices that help improve patient care and outcomes. Reliable information about the coronavirus covid19 is available from the world health organization current situation, international travel. Clinical resources to help improve the quality of care.

The interqual book gets updated almost every other. Implementation of the 2017 interqual criteria health. Interqual level of care criteria change healthcare. A variety of clinical resources, including care management programs, infection control, and online education, help you address the clinical needs of your healthcare facility. Interqual level of care criteria, interqual behavioral health criteria, interqual. Interqual level of care acute criteria adult 2004 mckesson on. Interqual level of care criteria 2010, acute care, adult. So the goal is for the patient to be in the appropriate level of care based on interqual guidelines. Criteria pointsrefer to test results, medications, symptoms findings, or medical management.

Interquals comprehensive portfolio includes five content suites. Oclcs webjunction has pulled together information and resources to assist library staff as they consider how to handle coronavirus. Refer to an introduction to the asam criteria for patients and families for additional description. Interqual acute criteria acute adult criteria innovating. Interqual mobile is currently available for the following interqual criteria products. Numerous and frequentlyupdated resource results are available from this search. Interqual level of care criteria the interqual level of care products cover the continuum of care. The full list of medical policies and clinical utilization management um guidelines are publicly available on the medical policy and clinical um guideline subsidiary website. Mckesson brings interqual criteria to the cloud youtube. Interqual application and training tenet healthcare.

Qp10518 interqual level of care criteria for authorizations. Together with our clinical resource team, weve developed these robust resource programs to help you tackle some of your biggest care management challenges. The conditionspecific format presents evidencebased interventions that are specific to the condition and help to costeffectively improve outcomes. Care guidelines for evidencebased medicine mcg health. Mckesson interqual level of care criteria 20 mckesson on. Interqual level of care criteria 2010, longterm acute care, adult. Longterm acute care medically complex respiratory complex ventilator weaning woundskin each admission request is evaluated individually to determine the appropriate level of care.

Data analysis provides insight into critical benchmarks such as length of stay, readmissions. Interqual level of care criteria 2012, acute care adult. Their purpose is to help you provide quality care by reducing inappropriate use of medical resources. You may like interqual observation vs inpatient admission 2019. Benchmark length of stay and care management guidance content facilitates a more holistic view of the patient and adds support to transitions of care. Care guidelines from mcg provide fast access to evidencebased best practices and careplanning tools across the continuum of care, supporting clinical decisionmaking and documentation as well as enabling efficient transitions between care settings. On this date, the modifications outlined below will take effect, and all previous modifications and interqual criteria will be replaced with these guidelines. With practical features such as bookmarks, annotations, and highlighting, you can easily find your most important or frequently used criteria as well as leave notes or comments for yourself about certain criteria sections. Criteria in decisiontree format have these features. Mckesson interqual is an evidencebased clinical criteria that provides support covering medical and behavioral health across all levels of care as well as care planning and complex care management. Criteria points support the reasons or indications.

Interqual criteria also updated, augmented for broader care management versatility. With the book, i can eyeball straight down the page in 2 seconds and move on. Interqual aligns payers and providers with actionable, evidencebased clinical intelligence to support appropriate care and foster optimal utilization of resources. The acute criteria address the observation, critical, intermediate, and acute levels of care and an additional 4 levels of nursery care in pediatrics that include. Mckessons interqual criteria for medical necessity and. Level of care means the level of inpatient or outpatient services a.

The richness of clinical detail allows for consideration of. Interqual level care criteria mckesson interqual level of care criteria 20. Change healthcare introduces interqual 2019 business wire. The interqual content portfolio consists of four product sets.