Turn off pop-up blockers and other tips to successfully complete InterQual® reviews in GuidingCare
Authorization are taking longer to complete because InterQual reviews are being ignored or completed incorrectly. Use these tips to get your authorizations reviewed with less delay.
Make sure your pop-up blockers are turned off when using GuidingCare and that you fully complete InterQual when submitting your authorizations.
Background
On Jan 1. 2022, we completed the transition of our musculoskeletal and spine authorization from eviCore to GuidingCare. In GuidingCare, some authorizations require the completion of InterQual.
You don’t need to remember which authorizations require InterQual because a window will “pop-up” to guide you through the InterQual process.
InterQual tips
Avoid missing InterQual reviews by making sure your pop-up blockers are turned off. Find instructions on how to do this on page 6 of the GuidingCare manual.
In addition, use these tips to successfully complete InterQual reviews in GuidingCare:
- Attach clinical documentation –The clinical documentation must support your InterQual review selections.
- Take your time fully reading InterQual questions –Your answers must match what is happening with your patients.
- Don’t select the free text option – This automatically pends your authorization for review.
- Use consistent medical terminology – The supporting clinical documentation your attach to your authorization must include consistent medical terminology with how you answer InterQual review questions.