October 17, 2018
Implementation of the 2018 InterQual Criteria
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.).