InterQual^® criteria used as guidelines in reviewing BCN acute inpatient medical admissions

While Blue Care Network uses McKesson's InterQual criteria as guidelines in reviewing acute inpatient medical admissions, BCN's medical directors will make the final determination about the most appropriate level of care based on their medical judgment. This will be effective starting May 30, 2016.

Additional information about the InterQual criteria and about the process for reviewing these admissions is found in the Care Management chapter of the BCN Provider Manual.

Posted: May 2016
Line of business: Blue Care Network