For UR Directors & Revenue Cycle Managers in Behavioral Health

Faster authorizations. Fewer denials.

CriteriaIQ gives utilization review directors and revenue cycle managers at behavioral health treatment facilities and billing companies AI-powered tools to support medical necessity documentation, fight denials, and speed up authorizations.

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Time saved per clinical criteria analysis
47m
Average time saved per clinical criteria analysis using CriteriaIQ versus manual criteria review.
Denial overturn rate
65%
Of denied behavioral health claims that are appealed are ultimately overturned — most facilities never appeal.
Analysis frameworks
19
ASAM, MCG, InterQual, and LOCUS analysis buttons covering every level of care and criteria framework.
Two Products. One Mission.

Built for how behavioral health
revenue cycle actually works.

Whether you need a Chrome extension for your Kipu EMR workflow or a full multi-tenant RCM platform, CriteriaIQ has you covered.

Chrome Extension — Works in Kipu EMR
Criteria Analyzer
AI-powered medical necessity analysis directly inside your Kipu EMR workflow. Scrapes the patient chart, analyzes against clinical criteria, and generates medical necessity documentation in under 60 seconds.
  • ASAM 4th Edition — all 6 levels of care
  • Milliman MCG — Residential, PHP & IOP
  • InterQual BH — Inpatient, PHP & IOP
  • LOCUS 4th Edition Assessment
  • Phone review scripts & appeal letters
  • Works on your existing Kipu account
Start free trial →
Full RCM Platform — Multi-Tenant
CriteriaIQ RCM
Complete utilization review management for behavioral health billing companies. Tracking, eligibility verification, denial management, client portal, and Kipu or BestNotes EMR integration — all in one platform.
  • Utilization review & concurrent review tracking
  • Denial management with appeal deadlines
  • Eligibility verification & VOB
  • Client portal for facilities
  • Analytics & AR aging reports
  • Kipu or BestNotes EMR sync & API webhooks
Sign in to RCM →
Why CriteriaIQ

Built by a UR professional.
For UR professionals.

20 years of behavioral health utilization review experience built into every feature. No generic healthcare software — purpose-built for how clinical criteria analysis actually works.

⚕
ASAM 4th Edition
Complete subdimensional risk ratings and clinical probability for all six ASAM levels of care. Initial and concurrent review.
🧠
Milliman MCG
MCG criteria analysis for Residential, PHP, and IOP — both initial and concurrent. PHQ-9 and GAD-7 integrated automatically.
📋
InterQual BH
Full InterQual Behavioral Health criteria with explicit lettered sub-criterion citations. Inpatient, PHP, and IOP.
📊
LOCUS Assessment
All 7 LOCUS dimensions scored against 4th Edition criteria with composite score and level of care recommendation.
✍
Appeal Letters
Framework-specific appeal letters generated in one click from any analysis. Cites the exact criteria the payer used to deny.
💊
Kipu EMR Integration
Scrapes clinical documents, medications, assessments, and insurance data directly from the live Kipu patient chart.
Ready to strengthen medical necessity documentation?

Start your 14-day free trial today.

Card required — not charged until trial ends. Works on your existing Kipu account. Cancel anytime.

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© 2026 CriteriaIQ — Cavan Ventures, LLC · Deerfield Beach, Florida · HIPAA-Ready · support@criteriaiq.com