Viewing Decision Reasons

InterQual^® Decision Reasons helps to author consistent communications to members and providers that include clear and specific clinical reasons for decisions regarding medical necessity when making a final non-determination decision.

View Decision Reasons in a decision-tree review

Select DECISION REASONS.

The Decision Reasons content includes a patient education statement that introduces the clinical scenario, including the requested level of care.
Select a plus sign to expand a Decision Reasons section and select a minus sign to collapse it.
When you have finished viewing Decision Reasons, continue with any of the following:
Select Change Subset to view criteria for a different subset
Select Previous to return to the Subset Overview screen
Select Menu to exit the workflow and then, optionally, select an option from the navigation pane

View Decision Reasons in a Q&A review

Select DECISION REASONS.

The Decision Reasons content includes a patient education statement that introduces the clinical scenario.
Select a plus sign to expand a Decision Reasons section and select a minus sign to collapse it.
When you have finished viewing Decision Reasons, continue with any of the following:
Select Change Subset to view criteria for a different subset
Select Previous to return to the Subset Overview screen
Select Menu to exit the workflow and then, optionally, select an option from the navigation pane