posted on April 29, 2019
BEDFORD, MA.,- Casenet® LLC, a population health company, is launching an integration with Change Healthcare's InterQual Connect™ that enables providers and payers to access evidence-based content to streamline authorization requests and facilitate utilization review.
InterQual Connect is a cloud-based medical review and connectivity solution that automates prior authorizations where medical review is required. The integration enables providers to review InterQual® clinical criteria and submit authorization requests to payers using TruCare ProAuth™, Casenet's authorization prescreening, submission, and tracking technology solution. Payers can view the authorization request immediately and approve, or deny, the request in Casenet's care management platform, TruCare. In addition, payers can accelerate the approval process by automating business and clinical rules using InterQual Connect's criteria, eliminating manual review and providing a real-time decision to providers.
Integration with InterQual Connect provides an easy, step-by-step process that enables providers to quickly document and share information with payers to support their authorization requests. Payers can view authorization requests in real time, access InterQual clinical criteria to confirm medical necessity, and make utilization decisions. Providers are notified about authorization decisions immediately via TruCare ProAuth.
“Health plans and providers need to collaborate on overall patient outcomes using evidence-based clinical decision support. The InterQual Connect integration with both the TruCare care management platform and TruCare ProAuth enables healthcare organizations to collaborate effectively and in their desired workflow”, says Nilo Mehrabian, Vice President of Product Management, Decision Support at Change Healthcare. “We are pleased to partner with Casenet as they fully leverage InterQual Connect authorization connectivity and medical review services to address automation of authorizations requiring medical review.”
“Casenet's integration with InterQual Connect solves the problems with manual data entry, back-and-forth faxes, and follow-up calls that have hampered the authorization process,” said Peter Masanotti, CEO of Casenet. “Now we can open up communication channels between physicians and care managers, creating opportunities to automate the prior authorization process and streamline utilization management to support value-based care initiatives.”
About Casenet, LLC
Casenet provides a comprehensive suite of enterprise care management software and services solutions for commercial, Medicaid, Medicare, TPA, provider/ACO and specialty provider organizations that have multiple lines of business and that require comprehensive configurations for each member population. Healthcare organizations rely on Casenet's population health management solutions to improve care coordination and the quality and delivery of care through enhanced case, disease, utilization, and home and community-based services management. Casenet solutions enable organizations to adapt quickly to changing market and regulatory dynamics, and to identify and target populations having unique risk characteristics with specific care management programs— taking the first step toward better individual health and total population health management. For more information, visit http://www.casenetllc.com.
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