Comparison · CriteriaIQ vs Kipu

CriteriaIQ RCM
vs Kipu.

Kipu is a clinical EMR — and if you're running it, this isn't really a "vs." CriteriaIQ RCM isn't a Kipu alternative or a Kipu competitor. It's a UR and denial-management layer that syncs with the Kipu account you already run, adding purpose-built ASAM/MCG/InterQual criteria analysis, authorization tracking, and denial management on top — no migration required.

See CriteriaIQ RCM Pricing

Not a replacement —
a layer on top.

 CriteriaIQ RCMKipu
What it isA UR & denial-management layer that syncs with your existing Kipu accountA full clinical EMR — charting, scheduling, admissions, billing
Migration requiredNo — connects via API using your existing Kipu credentialsN/A — you're already on it
UR & criteria focusPurpose-built ASAM 4th Edition, Milliman MCG, and InterQual BH matching with phone scripts and appeal lettersGeneral billing and claims as part of the broader EMR suite
Denial management13 denial categories, CARC/RARC tracking, appeal deadline countdowns, overturn analyticsNot a dedicated UR/denial specialty within the platform
Published pricingYes — $299 to $4,999/mo, public rate cardNot publicly listed — quote-based
Free trial14 days, no credit cardDemo request required

Keep charting in Kipu.
Add denial control on top.

Kipu is a strong clinical EMR, and if it's already running your charting, scheduling, and admissions, that's not a problem CriteriaIQ tries to solve. What Kipu's general billing tools don't do is the deep, criteria-specific work of utilization review: matching a chart against ASAM 4th Edition, Milliman MCG, or InterQual BH line by line, tracking authorization countdowns, and managing denials by CARC/RARC code with appeal deadlines.

CriteriaIQ RCM connects to your existing Kipu account via API and pulls active patients in automatically. Your clinical team keeps charting exactly where they chart today. What changes is what happens with authorizations, denials, and criteria review after that.

  • No chart migration or clinical workflow retraining
  • Live in days, syncing with the Kipu account you already have
  • Works alongside Kipu, not instead of it
  • Add authorization tracking, denial management, and criteria analysis without touching what's already working

Before you add a layer.

Is CriteriaIQ a replacement for Kipu?
No. Kipu is your clinical EMR — charting, scheduling, admissions. CriteriaIQ RCM is not a Kipu competitor; it's a layer that syncs with your existing Kipu account via API and adds purpose-built utilization review, authorization tracking, and denial management on top of it. You keep charting in Kipu exactly as you do today.
Does Kipu already handle UR and billing?
Kipu covers general billing and claims as part of its broader EMR suite. CriteriaIQ RCM is purpose-built specifically around the UR workflow — ASAM 4th Edition, Milliman MCG, and InterQual BH criteria matching, authorization countdown tracking, P2P scheduling, and structured denial management with CARC/RARC codes — which is a narrower, deeper focus than a general EMR's billing module.
How does the Kipu sync work?
CriteriaIQ RCM connects to your existing Kipu account via API using your own Kipu credentials. Active patients sync into authorization records automatically — no manual re-entry, no chart migration, and no disruption to clinical workflows already running in Kipu.

See the layer,
not the migration.

14-day free trial. No credit card required. Connects to your existing Kipu account.

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CriteriaIQ is an independent product and is not affiliated with, endorsed by, or sponsored by Kipu Health. References to Kipu describe interoperability via customer-authorized API access only. Comparison reflects publicly available information about Kipu's platform, reviewed August 2026 — verify current Kipu features directly with Kipu before deciding. CriteriaIQ RCM figures reflect our own published rate card.