The U.S. Department of Veterans Affairs (VA) recently reaffirmed InterQual as its criteria of choice with a new multi-year agreement across the entire VA health system. With this new agreement, the VA will continue to use InterQual across its 18 Veterans Integrated Service Networks (VISNs), more than 150 medical facilities, and several program offices. The Veterans Health Administration (VHA) is committed to a healthcare system that treats its patient population effectively, efficiently, and appropriately. The objective of the VA’s utilization management program is to provide the right care, for the right patient, at the right time and for the right

There are few things everyone in healthcare agrees on. But there is one area where payers, providers, physicians, and patients are all on the same page: prior authorization. Nobody likes it. That ...

Kevin Weeks, who serves as Director of Industry Engagement for Change Healthcare and is a Fellow of the American College of Healthcare Executives (ACHE), was recently featured in an ACHE video ...

A Mississippi Medicaid program called the Complex Pharmacy Care Program has helped save nearly $5 million in unneeded prescriptions thanks to contractor Change Healthcare and a pharmacist ...

Managing a medical practice today leaves little bandwidth for much beyond what is necessary to maintain quality care, achieve regulatory compliance, and remain cashflow positive. So, it’s no ...

In an ideal world, physician practices would reach equitable terms in every payer negotiation and there would be no need to consider going out-of-network. But in today’s marketplace, incompatible ...