The ASAM Criteria Navigator is a specialized software tool developed through an exclusive partnership between the American Society of Addiction Medicine (ASAM) and Optum (InterQual). Its primary function is to serve as an interactive utilization management (UM) solution for healthcare organizations, payers, and providers. The tool brings the comprehensive standards of The ASAM Criteria (4th Edition for adults and 3rd Edition for adolescents) into a structured, easy-to-use Q&A format. It is designed to streamline and improve the medical review process for Substance Use Disorder (SUD) patients, helping to make consistent clinical decisions regarding level of care, admission, transfer, and continued stay determinations. The Navigator significantly reduces the time required for patient assessments, with reviews completed in under 15 minutes, compared to up to 30 minutes without the tool. It supports the review of all six ASAM assessment dimensions and is validated by ASAM experts for accuracy. A key benefit is its ability to help organizations meet regulatory and legislative requirements for the use of evidence-based medical necessity criteria, including mandates from CMS, NCQA, and URAC. Optum also provides in-depth education and training to support the transition and effective use of the criteria.
Disclaimer: This page is an independent third-party listing and is not affiliated with, sponsored by, or endorsed by ASAM Criteria Navigator or ASAM. All product names, logos, and brands are property of their respective owners.
OVERVIEW
An interactive utilization management (UM) solution, powered by InterQual, for applying The ASAM Criteria to streamline Substance Use Disorder (SUD) patient reviews.
RATING & STATS
Founded
2021
KEY FEATURES
- ✓Interactive Q&A for ASAM Criteria application
- ✓Substance Use Disorder (SUD) Level of Care Determination
- ✓Utilization Review and Management Workflow Support
- ✓Supports ASAM Criteria 4th Edition (Adult) and 3rd Edition (Adolescent)
- ✓Reduces assessment time (to under 15 minutes)
- ✓Covers all 6 ASAM assessment dimensions
- ✓Improves interrater reliability and consistency
PRICING
Model: enterprise
Pricing is not publicly disclosed and is handled via enterprise contract with Optum/InterQual for utilization management solutions.
TECHNICAL DETAILS
Deployment: saas, cloud
Platforms: web
USE CASES
Utilization Management for SUDLevel of Care Placement and AssessmentAdmission, Transfer, and Continued Stay DeterminationsMeeting Regulatory Requirements (CMS, NCQA, URAC)
INTEGRATIONS
InterQual (Optum)
COMPLIANCE & SECURITY
Compliance:
HIPAANCQAURACCMS Mandates
SUPPORT & IMPLEMENTATION
Support: training
Target Company Size: medium, enterprise
TRAINING AVAILABLE
PROS & CONS
✓ Pros:
- +Ensures consistent and accurate application of The ASAM Criteria
- +Significantly reduces utilization review time (under 15 minutes)
- +Helps organizations meet critical regulatory and legislative requirements (CMS, NCQA, URAC)
- +Developed and validated through exclusive partnership with ASAM and Optum/InterQual
✗ Cons:
- -Pricing is not public (Enterprise model)
- -Limited public information on technical specifications (API/mobile)
- -Primarily focused on Utilization Management rather than comprehensive clinical assessment
TRY IT OUT
ABOUT ASAM
Other software by ASAM:
• ASAM CO-Triage (Substance Abuse Treatment → SUD treatment planning (ASAM criteria))
• ASAM CONTINUUM (Substance Abuse Treatment → SUD treatment planning (ASAM criteria))
RELATED SUD TREATMENT PLANNING (ASAM CRITERIA) SOFTWARE
BROWSE SOFTWARE IN SUD TREATMENT PLANNING (ASAM CRITERIA)
No next software