Enable automated authorization within existing workflows

The prior authorization process can be manual and inefficient, with payers and providers often creating redundant medical reviews, and information flowing between organization through phone, fax and email. The resulting administrative burden is a cost of between $50-$100 per authorization¹, a frustration with the process on both ends, as well as potential delays in care that could present a risk to patients.

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With InterQual Connect, payers can expand automated authorization to include requests that require a medical review, within their existing systems. Providers can receive quicker authorization approvals for most requests and payers only need to interact with the exceptions that can’t be approved automatically. This can reduce the need for duplicative medical reviews and the time spent on routine authorizations.

InterQual Medical Review & Authorization

InterQual Connect is a flexible SaaS solution, integrated into payer and provider health information systems. It pairs the leading InterQual® Criteria, now available as a web service, with proven and secure connectivity.

  • A unique solution: The only integrated solution to enable full auto authorization, including medical review.
  • Uses existing IT infrastructure: No new hardware, software or IT staff required.
  • Is easy to implement: When using a certified Studiomaca Alliance Partner.
  • Provides fast, secure connectivity: Uses the proven InterQual authorization gateway.
  • Keeps users in existing workflows: Providers submit an authorization request, and payers receive the request and medical review from within their current UM/CM workflow. 
  • Delivers real-time InterQual access: Just-in-time content from our cloud platform helps ensure you get the latest version, but you can choose when to make the switch. 
  • Aligns with InterQual hospitals: Payers benefit from the shared clinical language with 3,700 InterQual hospitals plus a direct connection to 1,000+ hospitals already connected to the InterQual Connect cloud.
  • Supports payer/provider collaboration: Helps reduce the costs and hassle of prior authorization, while providing transparency into payer criteria for providers.

Download the InterQual Connect Fact Sheet (PDF, 1.11 MB)

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¹Studiomaca 2014 study conducted with CAQH index data.