UnitedHealthcare is transitioning to InterQual criteria

We will transition to InterQual criteria for all benefit plans effective May 1, 2021. We expect that using InterQual will further streamline our current clinical review processes while helping to reduce clinical decision turnaround times.

What is InterQual?

InterQual criteria are nationally recognized, evidence-based clinical criteria that we’ll use for utilization management for all our benefit plans.

No disruption to your processes

The change to InterQual is happening within our internal technology structure. This should be seamless to care providers using our online portals and other systems. Your processes shouldn’t be affected and your daily work shouldn’t be disrupted.

We’re here to help you

If you have questions, please contact your Provider Advocate, UnitedHealthcare network representative or call Provider Services at the number on the member’s ID card.