Medecision has integrated the Change Healthcare InterQual Connect medical review service into the iExchange provider data-entry solution. This press release was originally issued by Change Healthcare.
NEWTON, Mass., Oct. 28, 2019—Change Healthcare (Nasdaq: CHNG) announced today that Medecision, an integrated health solutions company that helps manage members in commercial, Medicare Advantage and Medicaid programs, has integrated the Change Healthcare InterQual Connect medical review service into its iExchange® provider data-entry solution. The continued partnership brings new capabilities, including real-time, automated authorization decisions for medical necessity from within existing workflows to a broad base of payers and their networked providers.
Providers can continue to request authorizations based on business rules, and now, clinical rules are also part of the new medical review capability. Authorizations are automated and quicker for providers, allowing payers to focus on exceptions that cannot be approved automatically. This eliminates duplicative medical reviews and wasted staff time on routine authorizations.
“InterQual Connect offers a unique capability to healthcare organizations by enabling automated authorizations that require a medical review within a payer’s existing workflows” said Nilo Mehrabian, vice president of Product Management, Decision Support, Change Healthcare. “These integrations with industry-leading solutions enable providers and health plans to benefit from a streamlined utilization management process that is more efficient, accurate, and exception-based.”
InterQual Connect is a flexible SaaS solution, integrated into payer and provider health information systems. It pairs the leading InterQual® Criteria, available as a web service, with proven and secure connectivity to fill the gap in current care management systems.
With Change Healthcare’s growing list of partnerships, more providers and health plans have been able to automate routine prior-authorization requests. This has allowed them to shift from reactive to proactive care and to dedicate more attention to complex cases.