Evidence-based criteria and technology for clinical decision making
Our innovative clinical content, technologies, solutions, and services have helped reduce the administrative burden, enhance payer-provider relations, and improve care quality. Our solutions support those committed to the passionate pursuit of quality outcomes without unnecessary cost.
Clinical Decision Support Solutions
Software
InterQual Criteria
Our comprehensive solution offers clinical decision support designed to strengthen patient outcomes and reinforce appropriate utilization.
Software
Industry Content Navigator
Get structured industry content to support consistent application of third-party content and policies and improve review workflow.
Software
InterQual Delivery
Streamline the medical review process with a variety of access options for using InterQual® Criteria.
Software
InterQual AutoReview
A medical review automation solution that increases utilization management (UM) efficiency and review accuracy.
Software
InterQual Coordinated Care
An integrated, cloud-based care coordination solution for complex care management.
Related healthcare insights
Article
See how Optum follows the science where it leads, validating the research we find to uphold the clinical integrity of InterQual content.
Article
Learn how Decision Reasons can help enhance patient communications by providing clarity, compassion and clinical accuracy.
Article
Learn how the InterQual level of care team tackled a content development challenge following updated societal guidelines for acute coronary syndrome.
Product information and resources
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Case study
InterQual case study
Explore how a large national health plan leveraged InterQual® solutions as the catalyst to transforming their UM and CM programs.