InterQual Evidence-based Criteria Helps Reduce Denials Transitions to Value-based Care
InterQual Evidence-based Criteria Helps Reduce Denials Transitions to Value-based Care
4 PagesInterQual Evidence-based Criteria Helps Reduce Denials as Health System Transitions to Value-based Care Customer Western Maryland Health System (WMHS), Cumberland, Maryland Challenge In return for more predictable revenue, WMHS entered a pilot project with strong incentives to reduce readmissions and promote healthcare outside the walls of the hospital. However, WMSH had denial rates of nearly 5% and began losing money under the ca
