As a reminder, Health Partners Plans uses McKesson’s InterQual^® criteria as a guideline for making medical necessity determinations. Effective November 15, 2018, we will implement the 2018 InterQual criteria in these modules:

• Acute Adult Criteria
• Acute Pediatric Criteria
• Long Term Acute Care Criteria
• Acute Rehabilitation
• Subacute & SNF
• Home Care Criteria
• Durable Medical Equipment
• Procedures Criteria
• Guidelines for Surgery and Procedures Performed in the Inpatient Setting

For more information, contact our Provider Services Helpline at 1-888-991-9023 (M-F, 9:00 a.m. to 5:30 p.m.).