All PlansPrior AuthHigh impact
Important update: InterQual Connect Prior Authorizations
UPMC Health Plan·PA · Cardiology, Radiology·Prior Authorization
Effective date
Mar 1, 2022
We identified it
Aug 7, 2026
Summary
Effective March 1, 2022, imaging and cardiology procedure prior authorizations previously managed by Health Help will transition to formal clinical reviews through InterQual Connect. MSK/Orthopedic reviews remain unchanged. Billing teams must ensure all prior authorization requests include complete information to enable auto-approval and avoid manual review delays.
Action Required
By March 1, 2022: Billing and authorization teams must update all prior authorization submission processes for imaging and cardiology procedures to route through InterQual Connect instead of Health Help. Implement quality assurance checks to verify complete information is included in all requests before submission to increase auto-approval rates and minimize manual review delays. Train staff on new submission requirements and InterQual Connect portal procedures. Verify that MSK/Orthopedic prior authorization workflows remain unchanged. Monitor claim denials post-implementation and address any incomplete submissions.