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Change Healthcare InterQual Connect Guidelines for Pega Care Management (PCM)
Easily Integrate with Industry Leading Medical Necessity guidelines.
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Overview
Seamless integration between Pega Care Management and the Change Healthcare InterQual®* solution provides clients with access to industry-leading, evidence-based medical necessity guidelines. With this connectivity, the review summary of guidelines generated by the InterQual review are maintained within the workflow and stored in the patient record as a basis for approving authorization requests along with real-time, bidirectional interactions with the InterQual Medical Review Service SaaS solution.
InterQual is a registered trademark of Change Healthcare, LLC and/or one of its subsidiaries
Key Features
- Access evidence-based guidelines through real-time, bidirectional interactions with the InterQual Medical Review Service SaaS solution
- Review Utilization Management guidelines within the workflow
- Manage authorization requests, admissions, initial and concurrent review, and discharge planning
- Integration ruleset for easy integration
- App Studio Configuration page for client specific integration points
Resources
Version
8.7
Compatible with
Pega Platform 8.7 Pega Care ManagementProduct Owner
Chip WarburtonLast updated
January 24, 2024Product Capability
Data Integration App Studio Installation and Deployment