Every level of care.
Every framework.
In under 60 seconds.
CriteriaIQ reads your Kipu patient chart and completes ASAM 4th Edition (Residential, PHP, IOP), Milliman MCG, InterQual BH, and LOCUS documentation — initial and concurrent — with full medication scans, CIWA/COWS scores, and PAWS documentation built in.
From chart to clinical analysis in
under 60 seconds
No copy-pasting. No form hunting. No generic templates. CriteriaIQ reads the live patient chart and writes complete medical necessity documentation — including medications, CIWA/COWS scores, and PAWS — for you.
Navigate to any patient in Kipu EMR. CriteriaIQ activates automatically in your Chrome toolbar. It immediately scans the chart for clinical documents, medications from the Medical and Med Log tabs, CIWA-Ar and COWS scores, and PAWS symptoms.
Select from 19 analysis buttons across ASAM (Residential 3.7/3.5, PHP 2.5, IOP 2.1), Milliman MCG, InterQual BH, and LOCUS — initial and concurrent for each. CriteriaIQ scrapes the full chart including medications, CIWA/COWS, and PAWS.
A complete, individualized clinical analysis appears in the overlay panel. Review auth probability, medications, PAWS documentation, CIWA/COWS scores, and all clinical justifications. Generate an appeal letter and export a print-ready PDF.
Every framework. Every level of care.
Initial and concurrent.
19 analysis buttons. 3 frameworks. 3 levels of care each. All with full-chart medication scanning, CIWA/COWS, and PAWS documentation built in.
All 12 subdimensional risk ratings with explicit point rubrics. Separate ASAM 3.7 and 3.5 authorization probability scores. Admission and concurrent review. Dimensional treatment plans for all 5 dimensions.
✓ Starter+Partial Hospitalization Program analysis using ASAM 4th Edition criteria. Explicitly documents why PHP is needed (not residential, not IOP). Auth probability with PHP-specific rubric. PAWS contribution to continued PHP need cited.
✓ Starter+Intensive Outpatient Program analysis. Cites why IOP is needed over standard outpatient (1.0). IOP schedule documentation (9+ hrs/week). PAWS as a specific IOP justification indicator. Auth probability with IOP-specific point rubric.
✓ Starter+Severity of Illness and Intensity of Service criteria scored for all three levels — MH Residential, PHP, and IOP. Each LOC has calibrated SI/IS sub-criteria and auth probability rubrics. PHQ-9, GAD-7, and PAWS integrated.
✓ Professional+InterQual BH Criteria — all four LOC sections applied correctly: Inpatient (§A), Residential (§B), PHP (§C — moderate/high stress), IOP (§D — broadest criteria). PHP and IOP use different additional NYS criteria than residential. Lettered sub-criteria cited.
✓ Professional+All 7 LOCUS 4th Edition dimensions scored. LOC 4 composite score evaluation (23–27). Visual LOC scale bar with all 7 coverage threshold pass/fail table. Auth probability and phone review script.
✓ Starter+CriteriaIQ scrapes medications from the Medical tab, Med Log tab, Doctor Orders, and recent clinical notes simultaneously — deduplicating across all sources. Up to 25 current medications with dosages, routes, and frequencies cited in every analysis.
✓ All PlansCIWA-Ar and COWS scores extracted from clinical documents and fed directly into ASAM Dimension 1 risk rating calculations with severity interpretation (CIWA ≥20 = Severe; COWS ≥25 = Moderately Severe). Cited in every withdrawal-related subdimension.
✓ All PlansPost-Acute Withdrawal Syndrome symptoms are scanned across all progress notes, nursing notes, psychiatry notes, and raw chart text. Named PAWS and symptom clusters (insomnia, cognitive fog, irritability, cravings) are cited as specific PHP/IOP justification indicators.
✓ All PlansEvery analysis generates a ready-to-read 150-word verbal summary for peer-to-peer review calls — citing correct framework criteria, dimensional drivers, auth probability rationale, and clinical evidence. No fumbling on the call.
✓ All PlansAppeal letters cite only the correct framework language — ASAM 4th Edition appeals never mention MCG or InterQual; InterQual appeals cite only InterQual BH Criteria section and lettered sub-criteria. Frameworks are never mixed.
✓ All PlansYour Anthropic API key lives on CriteriaIQ's servers — never in the browser. No PHI stored server-side. Google OAuth with 8-hour session TTL. Business Associate Agreement included on Enterprise plan.
✓ Enterprise BAAThe right criteria for
the right level of care
CriteriaIQ applies the clinically correct criteria for each level — PHP criteria are different from residential, and IOP criteria are different from PHP. The documentation justifies the specific LOC, not just "authorization in general."
Each level of care gets its own criteria, rubric, and clinical justification requirements
Residential (3.7/3.5) requires 24-hour monitoring justification. PHP (2.5) requires documenting why daily monitoring is needed but 24-hour care is not. IOP (2.1) requires justifying why 9+ structured hours per week are needed over standard outpatient. CriteriaIQ knows the difference.
- ✓ ASAM 3.7: Withdrawal 3B risk = +30 pts toward auth probability
- ✓ ASAM 2.5 PHP: Active psychiatric 2A/2B = +30 pts, PAWS = +8 pts
- ✓ ASAM 2.1 IOP: Readiness to change D/E = +20 pts, failed outpatient = +8 pts
- ✓ All: CIWA-Ar, COWS, PHQ-9, GAD-7, BAM-R automatically factored in
- ✓ All: Medications from Medical tab + Med Log + Doctor Orders merged
Why PHP not IOP: Active psychiatric 2A requires daily monitoring; PAWS affecting function.
PHP and IOP use different criteria sections than residential
The April 17, 2025 revision to InterQual BH Criteria requires only ONE additional NYS criterion (not all four). But the thresholds differ by LOC — §D for IOP accepts the broadest criteria, including "low stress" and "any level of support." Most tools apply the wrong section.
- ✓§ A/B Inpatient/Residential: HIGH/SEVERE stress required, non-existent support
- ✓§ C PHP: MODERATE/HIGH stress sufficient — lower threshold than residential
- ✓§ D IOP: LOW/MODERATE/HIGH stress — even "no problems" satisfies criterion [1]
- ✓§ D IOP: Supportive environment counts — does not need to be absent
- ✓Concurrent review timelines per policy: PHP from week 2, IOP from weeks 2–3
Merges medications from the Medical tab, Med Log, Doctor Orders, and recent clinical notes. Deduplicates across all sources. Up to 25 current medications with dosages, routes, and frequencies cited in every analysis automatically.
Latest CIWA-Ar and COWS scores extracted from clinical documents tab. Severity interpretation applied (CIWA ≥20 = Severe; COWS ≥25 = Moderately Severe). Fed directly into ASAM Dimension 1 risk rating calculations and cited in withdrawal subdimension justifications.
Post-Acute Withdrawal Syndrome scanned across all progress notes, nursing notes, and psychiatry notes. Named PAWS and implicit symptom clusters (insomnia, cognitive fog, irritability, cravings, fatigue) both detected and cited as PHP/IOP medical necessity justification indicators.
Pricing that pays for itself
the first day
At $0.38–$1.50 per analysis, CriteriaIQ costs less than 2 minutes of your UR clinician's time. Every plan includes a 14-day free trial.
- ✓ ASAM 3.7/3.5 Residential (Initial & Concurrent)
- ✓ ASAM 2.5 PHP (Initial & Concurrent)
- ✓ ASAM 2.1 IOP (Initial & Concurrent)
- ✓ LOCUS 4th Edition Assessment
- ✓ Appeal Letter Generation
- ✓ Full medication scan (Med Log + Medical)
- ✓ CIWA-Ar & COWS auto-scoring
- ✓ PAWS documentation
- ✓ Phone review scripts
- ✓ PDF export
- ✗ Milliman MCG (any LOC)
- ✗ InterQual BH (any LOC)
- ✗ Facility flat-rate pricing
- ✓ Everything in Starter (all 6 ASAM buttons)
- ✓ MCG — MH Residential (Initial & Concurrent)
- ✓ MCG — PHP Initial & Concurrent
- ✓ MCG — IOP Initial & Concurrent
- ✓ InterQual BH — Inpatient/Residential
- ✓ InterQual BH — PHP Initial & Concurrent
- ✓ InterQual BH — IOP Initial & Concurrent
- ✓ Auth probability breakdowns for all LOCs
- ✓ Phone review scripts
- ✗ Facility flat-rate pricing
- ✗ Admin dashboard & BAA
- ✓ All 19 analysis buttons — every framework & LOC
- ✓ Up to 15 seats — one flat monthly rate
- ✓ Unlimited analyses for the whole team
- ✓ All ASAM, MCG, InterQual, LOCUS buttons
- ✓ Facility admin dashboard
- ✓ Usage analytics & reporting
- ✓ Business Associate Agreement (BAA)
- ✓ Priority email support
- ✓ Team license key activation
- ✓ Additional seats at $59/seat/month
All plans include a 14-day free trial · No credit card required · Cancel anytime
BAA available on Enterprise · Questions? support@criteriaiq.com
What UR clinicians are saying
The PHP and IOP buttons changed everything for our step-down documentation. It actually knows the difference between ASAM 2.5 and 2.1 criteria — and it documents why the patient isn't ready for the lower level of care. That's the hardest part to write by hand.
I've been doing InterQual reviews for InterQual BH members for years. CriteriaIQ is the first tool that actually applies the right policy section — it knows that IOP gets Section D, which has lower stress thresholds than Section A for inpatient. That specificity matters in peer-to-peer reviews.
The PAWS and CIWA/COWS integration is what sold me. It pulls scores I didn't even realize were in the chart and cites them directly in the PHP authorization. My denial rate dropped after we started using CriteriaIQ because the documentation is just more thorough than what we were writing manually.
Common questions
20 analysis buttons.
One click each.
ASAM residential, PHP, and IOP. MCG. InterQual BH. LOCUS. All inside Kipu EMR. 14-day free trial — no credit card required.
Available on the Chrome Web Store · Works with all Kipu EMR accounts · Enterprise BAA available