McKesson InterQual is an Evidence-Based Clinical Criteria that provides support covering medical and behavioral health across all levels of care as well as care planning and complex care management. InterQual's comprehensive portfolio includes five content suites: InterQual Level of Care Criteria, InterQual Behavioral Health Criteria, InterQual Care Planning Criteria, Content Powered by InterQual and InterQual Coordinated Care Content. InterQual Criteria connects and aligns payers, providers and other organizations with evidenceâbased clinical intelligence that helps care management decisions, support care, manage medical resources.
HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment / eligibility, benefit administration, provider contracting / reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more.
