Creating InterQual^® SmartSheets

InterQual^® SmartSheets provide a concise format of InterQual Criteria that helps facilitate communication between payers and providers. Using SmartSheets as part of the prior authorization process enables healthcare providers and reviewers to provide the payer with detailed medical documentation and patient information in support of the prior authorization process.

ⓘ  Note: Applies to InterQual^® Outpatient Rehabilitation & Chiropractic; Behavioral Health Services; InterQual^® Care Planning: Durable Medical Equipment, Imaging, Molecular Diagnostics, Procedures, and Specialty Rx (Oncology and Non-Oncology) products, and all Medicare Criteria Powered by InterQual^® products.

Create a SmartSheet as follows:

• Select a subset.

• Click .

  The SmartSheets screen appears and shows the Results Count, which indicates the number of services for the selected subset.

• Optionally, narrow your search for services by entering keywords in the Requested Service field.
• Select a service by clicking an option under Print Select.
• Optionally, change or select the following, as appropriate:
• Age—Click the list and select a different age range.
• Indication—Click the list and select a specific indication or include all indications by leaving All Indications selected. (Indications are the reason for a requested service.) For example, if your requested service is Appendectomy, then the reason your requesting that service might be Suspected Appendicitis.

• Depending on the options available, click Open or click .

• Use the controls in the PDF to save and/or print the PDF.

  ⓘ  Note: At any time, you can click Change Subset to return to the Select Subset screen and select a different subset. Any selections you made are cleared. Additionally, you can return to a previous screen by clicking Previous or clicking Menu and selecting an option from the navigation pane. To return to the SmartSheets screen, click SmartSheets. Any selections you made are retained.