May 29, 2020
Health Partners Plans values your participation and we're always working to provide clear, consistent utilization management guidance.
As a reminder, Health Partners Plans uses McKesson’s InterQual® criteria as a guideline for making medical necessity determinations. Effective October 7, 2019, we implemented the 2019 InterQual criteria in these modules:
- Acute Adult Criteria
- Acute Pediatric Criteria
- Long Term Acute Care Criteria
- Acute Rehabilitation
- Subacute & SNF
- Home Care 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.). As always, thank you for your service to our members.
May 29: Full letter to providers