InterQual
Date: 07/13/22
Managed Health Services (MHS) is pleased to announce beginning September 1, 2022, we will be implementing InterQual for authorization medical necessity review criteria. This will replace MCG regarding medical necessity review determination guidelines for all MHS product lines.
MHS values the relationships we have with our provider partners and works to ensure that doing business with us is easy and straightforward. This transition will enhance the ease of authorization review and Provider Portal streamlining, allowing provider partners to submit authorization requests from the convenience of their desktops seamlessly and in real time.
In conjunction with the change to InterQual for medical necessity determination, we are integrating an exciting new tool, InterQual Connect™, into our Secure Provider Portal. This new tool adds features that will simplify the provider experience and offers several new capabilities including:
- Streamlined web authorization requests
- Easy access to InterQual Connect to complete medical necessity reviews
- Completed InterQual medical necessity reviews will automatically be included with your web authorization submission
- Possible same-day approval based on outcome of a completed InterQual medical necessity review
- Identifies non-submitted Service Lines and provides reason for non-submittal
To facilitate authorization requests, providers can submit requests to MHS as follows:
- MHS Provider Portal @Mhsindiana.com (preferred)
- Fax 1-866-912-4245
- MHS referral line at 1-877-647-4848
We believe that the transition to InterQual, coupled with the enhancements to our Provider Portal will create a more user-friendly experience and enhance your ease of doing business with MHS. We hope you will take a moment to explore them.
Please contact MHS Provider Services at 1-877-647-4848 with any questions you may have.