Montana-Based Quality Improvement And Utilization Review Organization Expands Use Of InterQual Evidence-Based Criteria With Behavioral Health

Montana-Based Quality Improvement and Utilization Review Organization Expands Use of InterQual Evidence-Based Criteria with Behavioral Health

  • November 14, 2017

Mountain-Pacific Quality Health (Mountain-Pacific) has been a long-time user of InterQual® Criteria, including the Level of Care and Care Planning Criteria suites. Now, in a move to expand its offerings, the Montana-based organization has added InterQual Behavioral Health Criteria for Medicaid utilization reviews. For more than two decades, Mountain-Pacific clinicians have combined clinical knowledge and experience, documented clinical evidence, and utilized InterQual Criteria to make appropriate medical necessity and utilization decisions for hospital admissions. The addition of Behavioral Health will enable them to widen their offerings even further, as Mountain-Pacific uses InterQual inpatient behavioral health criteria for the utilization review…

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7 Strategies To Prevent Claims Denials

7 strategies to prevent claims denials

  • November 13, 2017

Claims denials are a prevalent, costly problem for healthcare today, but there are steps hospitals can take to lessen the impact. That was the takeaway from a recent webinar sponsored by Change Healthcare and featuring Change Healthcare AVP Carmen Sessoms, according to a story in Becker’s Hospital CFO Report. Read the article

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A Majority Of States Are Now Buying Into Value-based Care

A majority of states are now buying into value-based care

  • November 13, 2017

Value-based care and alternative payment models are coming on strong in healthcare across the United States. Healthcare Finance reports a new study by Change Healthcare found more than 40 states are already pursuing value-based payment programs. Read the article

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Report Shines Light On ACO Successes, Strategies

Report shines light on ACO successes, strategies

  • November 13, 2017

A roundup of recent research reports sheds light and insight into ACO strategies nationwide. Among the reports featured was Change Healthcare's new value-based reimbursement state-by-state study, which was released this week. Read the article

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