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Prior Authorization Request Procedure - Molina Healthcare
Oct 09, 2019Molina Healthcare, Inc. guidance documents and policies, including Molina Clinical Policy (MCP), Molina Clinical Review (MCR) and Drug Prior Authorization Criteria, 5. Third Party licensed proprietary clinical resources: InterQual® Criteria, MCG, American College of Radiology (ACR), 6. National Comprehensive Cancer Network (NCCN) 7.
A&M Rural and Community Health Institute
In striving to assist Texas rural hospitals in meeting utilization review requirements, the TAMHSC-Rural and Community Health Institute offers the availability of evidenced-based standards of care criteria through a group purchase option with McKesson Health Solutions called "InterQual Level of Care". Learn More
Suicide Assessment and Nurses: What Does the Evidence Show?
Jan 01, 2015Training programs for nurses. A third consistent theme noted in the literature was that training helps change attitudes and improve detection skills, yet the trainings provided can be drastically different. McKesson (2005). Interqual® behavioral health decision support tool: Evidence that works for payor and provider organizations.
Utilization Management in Healthcare | Smartsheet
Jan 09, 2020Utilization management (UM) is a process that evaluates the efficiency, appropriateness, and medical necessity of the treatments, services, procedures, and facilities provided to patients on a case-by-case basis process is run by — or on behalf of — purchasers of medical services (i.e., insurance providers) rather than by doctors.

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