October 19, 2017
Implementation of the 2017 InterQual Criteria
As a reminder, Health Partners Plans uses McKesson’s InterQual® criteria* as a guideline for making medical necessity determinations.
This week we successfully resolved a technical issue that had delayed the implementation of the 2017 criteria past our originally stated October 1 target date. As a result, we were able to implement the 2017 criteria on Monday, October 16.
Effective October 16, we have implemented the 2017 InterQual criteria in these modules:
- Acute Adult Criteria
- Acute Pediatric Criteria
- Long Term Acute Care Criteria
- Acute Rehabilitation
- Subacute & SNF
- Home Care Criteria
- Outpatient Rehabilitation and Chiropractic
- Durable Medical Equipment
- Procedures Criteria
- Guidelines for Surgery and Procedures Performed in the Inpatient Setting
* InterQual is a proprietary product of McKesson.