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Change Healthcare InterQual Guidelines for Pega Care Management
Easily Integrate with Industry Leading Medical Necessity guidelines.
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Overview
Seamless integration between Pega Care Management and Change Healthcare InterQual provides clients with access to industry-leading, evidence-based medical necessity guidelines. With this connectivity, the review summary of guidelines generated by Change Healthcare InterQual 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 Review Manager.
Key Features
- Access evidence-based guidelines
- Review UM requirements within the workflow
- Manage Admissions, concurrent review, and discharge planning
- Integration ruleset for easy integration
Resources
Version
8.7
Compatible with
Pega Platform 8.7Product Owner
Chip WarburtonLast updated
February 2, 2023Product Capability
Data Integration