NEWTON, Mass.--(BUSINESS WIRE)--There’s a bold new way to approach utilization management that, for the first time, gets payers and providers on the same page: InterQual Connect™, introduced today by McKesson. InterQual Connect unleashes the power of cloud connectivity to offer payers and providers an efficient workflow to automate medical review and authorization. And it works with the same care management systems and InterQual Criteria they already use, making it fast, easy, and cost-effective to implement and deploy.
Today the total cost of an authorization is between $35 and $100 when faxes, denials, appeals, and other aspects are considered, according to McKesson research1. Fully 13 hours of nursing time per physician per week is spent on pre-authorization, and 13% of physicians (and their patients!) wait over a week for an authorization, according to a Health Affairs study2. It’s no wonder, then, that an American Medical Association survey found reducing or eliminating the pain around pre-authorization is an important priority for 78% of physicians.3
“With InterQual Connect, we're changing the paradigm and creating a connected ecosystem where payers and providers are on the same page,” says Jackie Mitus, Senior Vice President and General Manager of Decision Management at McKesson Health Solutions. “This is crucial in an increasingly value-based world. The current system is laborious and inefficient, but with InterQual Connect, it becomes collaborative, connected, and efficient. It’s all about getting everyone aligned and improving the authorization experience. Now the whole ecosystem just works better.”
By fully automating the authorization process, redundancy—where both payers and providers perform medical reviews—can be eliminated. Now payers can use InterQual Connect’s secure connectivity and data exchange to receive the medical review and clinical information from their network providers, and send back notification or authorization, without ever leaving their existing systems. Often this can be done without ever needing to manually touch the request. This helps eliminate duplicate processes and manual work, enabling users to reduce administrative costs, speed authorizations, and ensure appropriate care.
Implementing InterQual Connect couldn’t be easier for payers whose CM/UM system vendors offer the integration. It doesn’t require new hardware or more IT staff, because it uses a payer’s current IT infrastructure to speed deployment, and minimize IT costs.
Providers gain visibility into the health plan's medical criteria, can digitally submit authorization requests, and receive fast auto authorization from within their existing workflow, using either the payer’s provider portal or their own InterQual workflow solution. And now they can obtain the prior authorization that payers require in a new way that helps cut the administrative burden, hassle, and delays.
InterQual Connect is part of the InterQual product line, McKesson's flagship decision support solution. InterQual Criteria help payers and providers ensure appropriate care which helps improve quality and reduce unnecessary cost across the medical and behavioral health continuums of care. The InterQual clinical development team synthesizes the most current, best evidence into a fully referenced decision support tool that is reviewed and updated annually. InterQual's development process, honed over nearly 40 years, is founded on rigorous review of the literature, and includes extensive peer review by practicing clinical experts across the United States.
For more information, visit InterQual Connect.com. For more information on McKesson Health Solutions, please visit our website, hear from our experts at MHSdialogue, and follow us on Twitter at @McKesson_MHS.
1McKesson study conducted in 2014 with CAQH index data
2“What
Does It Cost Physician Practices To Interact With Health Insurance
Plans?” Health Affairs, May 2009
3“Standardization of
prior authorization process for medical services whitepaper.” American
Medical Association, June 2011
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About McKesson Corporation
McKesson Corporation, currently ranked 11th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. McKesson partners with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit www.mckesson.com.
