Solution
InterQual® Level of Care Criteria
Evidence-based clinical decision support for payers and providers who want to assess safe and efficient level of care based on illness severity, comorbidities, and complications.
What’s Included in InterQual® Level of Care Criteria
Evidence-basedcriteria to support level of care decisions
Acute Care criteria to assess appropriate care level
Support effective, efficient care management by using criteria that are condition-focused and consider a holistic view of the patient to facilitate movement through the acute care continuum and decrease inappropriate admissions, avoidable days, and readmissions.
Spanning the full continuum of care to cover post-acute needs
Properly level the patient to the next least intensive setting by assessing clinical appropriateness for post-acute inpatient and outpatient services. The criteria help you ensure that there is timely movement of the patient along the care continuum, support functional recovery, and mitigate the risk of readmission.
Evidenced based and peer reviewed for reliable guidance
Produced using a rigorous development process based on the principles of evidence-based medicine (EBM) to help ensure accuracy, avoid bias, and give you complete confidence in the underlying guidance the criteria provide.
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Our outcomes
- InterQual® Ambulatory Care Planning Criteria Identify when imaging studies, procedures, DME, MDx tests, specialty pharmacy medications, and specialty referral consultations are appropriate. See how today. Learn more
- InterQual® Behavioral Health Criteria Discover how to manage the delivery of mental health and substance use care, including initial and concurrent level-of-care decisions. Learn more
- InterQual® Technology Explore our interactive desktop, mobile, and cloud options of accessing InterQual® Technology and streamlining the medical review process Learn more