Transform UM with AI, automation and clinical evidence
Our solution applies artificial intelligence (AI) to real-time clinical data extracted from the electronic health record (EHR) and robotic process automation to create and populate InterQual medical necessity reviews.
What's included in InterQual AutoReview
Automated medical reviews
Our EHR hub, robotic process automation and natural language processing extract and analyze both structured and unstructured EHR data. You can run automated reviews upon admission when a diagnosis is available or on-demand. Transmit reviews directly into case management systems, ready to be approved, finalized and transmitted to the payer.
Embedded EHR data
Leverage objective, codified InterQual criteria to support appropriate and provide transparent, defensible documentation for reimbursement, including embedded data from EHRs.
Key benefits
Improve transparency and defensibility.
Increase efficiency
Reduce administrative burdens by automatically populating InterQual medical reviews with data from your EHR within your existing workflow.
Improve accuracy
Increase payer trust with accurate, transparent medical reviews that contain embedded EHR data for each objective criteria point
Schedule a demo
Let us show you how to leverage our comprehensive, evidence-based clinical support solutions.
Related healthcare insights
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An Optum expert explains how hospital systems can transform their UM programs and drive efficiency with InterQual AutoReview.
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Learn more about why evidence-based criteria and clinician insight are needed for informed and trustworthy decisions while leveraging AI.
