Keystone Peer Review Organization Inc. (KEPRO) announced this week that it has agreed to its continued use of InterQual on a long-term basis.
KEPRO will utilize McKesson's InterQual for quality review in its state Medicaid contracts and Medicare reviews. The signed agreement renews KEPRO’s licenses for InterQual’s Level of Care, Behavioral Health and Care Planning Criteria.
KEPRO is an industry leading organization that helps improve quality and care management. It develops innovative solutions that help reduce resources while focusing on the quality of care provided for clients. KEPRO is one of two Benficiary and Family Centered Care Quality Improvement Organizations authorized by the Centers for Medicare & Medicaid Services (CMS) to audit short-stay claims. InterQual will be used by KEPRO to evaluate two-midnight short stays for the CMS based on clinical criteria. This will help in identifying and organizing proper care for clients.
InterQual helps advance decision-making on a clinical level in the areas of medical and behavioral health by providing measures constructed from evidence. InterQual then condenses the evidence compiled into a support tool that is updated and reviewed on a yearly basis.