OCMM Prior Authorization InterQual
For those who are contracted to use InterQual, this is the last step in the Medicare Hierarchy. This course will show you how to navigate and understand InterQual criteria, which are evidence-based criteria utilized to review prior authorization and inpatient requests. InterQual aids in determining medical necessity and level of care.
Demonstrate how to access and navigate InterQual Criteria.
Apply InterQual Criteria to determine medical necessity.
Use the Review Process document and other supporting documents for resources.
- 0.00 Attendance