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Solution

InterQual Coordinated Care

Our integrated, cloud-based care coordination solution helps payers and providers offer complex care management of high-risk members and patients with a single, blended care plan.

Manage high-risk and complex cases efficiently

You’re looking for ways to control medical costs of high-risk members and patients while preventing readmissions and improving outcomes.

Our solution, which is integrated into your workflow, allows you to assess and manage complex cases efficiently with a single, blended care plan, created from a patented assessment that merges condition components. Assessment questions cover medical, behavioral and social needs, in addition to comorbidities and cross-condition issues, allowing you to manage care holistically.

Efficiency and holistically manage high-risk and complex cases

Comprehensive assessments

The Primary Assessment addresses common care barriers, including SDOH. The care manager has the flexibility of adding one or more of 40 condition-focused modules to create a patient-specific blended assessment in real-time.

Personalized care plan

Merging assessment components for all relevant conditions enables the creation of a single prioritized care plan unique to the patient. Care plan outputs can be worked into your care management system workflow. Includes educational material for care managers and patients. Promotes self-management.

Easy integration

Integrate our cloud-based solution into homegrown or third-party care management delivery systems. Leverage the SaaS architecture to provide access across a networked system without increasing IT burden.

Supports compliance

Our solutions can help meet URAC (Case Management and Disease Management) as well as NCQA (HP-PHM5 and LTSS; MBHO-QI8 and LTSS; and SNP) program requirements.

Educational support

Reinforce education for specific conditions and condition management with companion member – and patient-acing fulfillment materials.

Key benefits

Efficiently and holistically manage the care of high-risk members and patients. 

Use patented, blended assessments

General case management and disease-specific questions are blended into a single rules-driven primary assessment.

Leverage personalized care plans

Merging assessment components for all relevant conditions enables the creation of a single prioritized care plan unique to the patient.

Support care managers and patients

Improve patient education with materials to guide care managers through the consistent presentation of condition-related information. 

Schedule a demo

Let us show you how to leverage our comprehensive, evidence-based clinical support solutions. 

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Current customer resources

Get reliable support

Our dedicated support team is available 24/7 to assist you. 


Get support

See how we can help you efficiently manage complex high-risk cases.

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