Why the process for Concurrent Review is important
Concurrent review is the process of reviewing for the continuation or extension of previously approved through ongoing care. The main focus will be on length of stay based on medical necessity and assurance that the patient is at the appropriate level of care. It will also include ongoing review of high cost or lengthy episodes of care.
Some patient admissions warrant closer scrutiny due to the illness of the member. The patient’s admission diagnosis will dictate which admissions are concurrently reviewed. This daily oversight by Integrated Plan’s medical professional has the purpose of facilitating the best possible medical outcome and careful coordination of the patient’s care. Concurrent review Registered Nurses working with the patients attending physical and under the guidance of Integrated Plan’s Medical Director will ensure the patient receives the most appropriate care specific to their medical diagnosis. Support services are made available to the patient and family to facilitate a smooth transition from the hospital to the next medically appropriate medical setting.
This medically intensive undertaking will occur under written policies and procedures designed to ensure that patients receiving concurrent review services of Integrated Plans are those where better medical outcomes with lower costs can be achieved.