InterSystems Announces Native Integration to Standardize Prior Authorization Workflows

InterSystems, a creative data technology provider powering more than one billion health records globally, is now using a native integration with InterQual® Exchange within its Payer Services Platform, designed to streamline how patient questionnaires are delivered and completed. This new capability, which is part of InterSystems Electronic Prior Authorization offering and aligned with CMS-0057-F requirements, integrates directly with InterQual®'s market-leading clinical decision support solution.

By incorporating support for adaptive questionnaires into a guided, automated experience, InterSystems Payer Services allows organizations to support InterQual's industry-proven evidence-based criteria and dynamically capture complete, structured clinical documentation at the point of decision-making. This automated approach reduces administrative burden, minimizes payer-provider back-and-forth, and ensures more comprehensive data submission upfront, ultimately accelerating prior authorization timelines and improving the experience for both patients and providers.

"Health plans are under increasing pressure to improve efficiency while maintaining rigorous clinical standards," said Don Woodlock, President of InterSystems. "By integrating InterQual directly into InterSystems Payer Services, we are enabling our customers to automate complex workflows with minimal configuration effort to gain trusted clinical intelligence and support faster, more consistent decisions."

Through the native integration with InterQual® Exchange, health plans can launch InterQual's evidence-based adaptive questionnaires directly within InterSystems Payer Services Documentation Templates and Rules workflows. The integration helps capture the clinical information needed for authorization decisions upfront, reducing administrative complexity while improving consistency and accuracy.

The adapter is delivered as a pre-integrated component of InterSystems Payer Services, giving organizations an enterprise-ready path to modernize prior authorization workflows with minimal configuration and faster time to value.

For more information about InterSystems Payer Services, visit our website.