This integration allows health plans to approve routine requests in real time and free up UM staff to focus on requests that require further medical review  Nilo Mehrabian, Change Healthcare Vice President 
Jan 7, 2020

Altruista Health Integrates InterQual Connect™ Solution to Automate Pre-authorizations in GuidingCare®

Change Healthcare partnership will benefit Altruista customers

(Jan. 7, 2020, Reston, Va.) – Altruista Health, an innovative provider of care management technology solutions for health plans and provider organizations, today said it is joining forces with Change Healthcare as a Validated InterQual Alliance Partner to deliver dramatically streamlined utilization management (UM) for Altruista customers who rely on the GuidingCare® technology platform.

“We are pleased to support Altruista Health in offering its customers automated pre-authorizations within the InterQual Connect medical review service. This integration allows health plans to approve routine requests in real time and free up UM staff to focus on requests that require further medical review,” said Nilo Mehrabian, Vice President of Product Management, Decision Support, Change Healthcare. “As an Alliance Partner, Altruista can support its health plan customers in strengthening payer-provider relationships.

GuidingCare has integrated the InterQual Connect medical review service into its UM module and connected it with GuidingCare’s module for provider access, driving easier, faster and more transparent prior authorizations in support of quality care. The exception-based design streamlines administrative workflow to reduce manual processes and redundant medical reviews. This integration will work with any version of GuidingCare.

“We have multiple Altruista customers already leveraging this capability within their current GuidingCare workflows,” said Craig Wigginton, Altruista Health Chief Technology Officer. “Health plans considering an upgrade to the InterQual Connect medical review service can rest assured that this integration has been tested and is in place.”

InterQual Connect is a flexible SaaS solution, integrated into payer and provider health information systems. It pairs with InterQual® Criteria, available as a web service, with proven and secure connectivity to fill the gap in current care management systems. This mutually beneficial connectivity and function supports value-based care and more resources available to caring for plan members.

About Altruista Health
Altruista Health delivers care management and population health management solutions that support value-based and person-centered care models. Our GuidingCare® technology platform integrates care management, care coordination and quality improvement programs through a suite of sophisticated yet easy-to-use web applications. GuidingCare is the largest and most widely adopted platform of its kind in the United States. Founded in 2007 and headquartered in the Washington, D.C. area, Altruista Health has grown into a recognized industry leader, and was named twice as one of the Top Population Health Management Companies to Know by Becker’s Healthcare. Health plans and healthcare providers use GuidingCare to transform their processes, reduce avoidable expenses and improve patient health outcomes.

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