Concurrent Reviews Medical Records

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How to Conduct a Medical Record Review - NCHA

https://www.ncha.org/wp-content/uploads/2018/11/ACDIS-White-Paper-How-to-Review-a-Medical-Record_2018.pdf

How to Conduct a Medical Record Review Appropriate reimbursement comes from the review’s capture of severity, clinical validation, coding accuracy, medical necessity, and …

Concurrent Review - Aetna

https://www.aetna.com/health-care-professionals/utilization-management/concurrent-review.html

A concurrent review also determines if the person’s plan covers the treatment under review. The concurrent review process includes: Collecting information from the care …

Concurrent Review | WPS

https://www.wpshealth.com/resources/provider-resources/concurrent-review.shtml

Concurrent review decisions are reviews for the extension of previously approved ongoing care. Examples are the review of inpatient care as it is occurring or ongoing ambulatory …

3 Varieties of HCC Coding Review: Prospective, …

https://www.rcxrules.com/blog/prospective-concurrent-retrospective-review

The Utilization Review Process and the …

https://www.mcg.com/blog/2018/06/21/utilization-review-medical-necessity/

Concurrent reviews include a review of medical necessity decisions made while the patient is currently in an acute or post-acute setting. Retrospective …

Medical Review and Education | CMS

https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Medical-Review

What sources of information do contractors use when selecting claims and subjects for medical reviews? Medical review activities, such as the Targeted Probe and …

Utilization Management in Healthcare

https://www.smartsheet.com/content/utilization-management

Concurrent Review: This type of review occurs during the course of treatment and tracks a patient’s progress and resource consumption; which may cause in …

Debate: Retrospective vs. concurrent data collection

https://www.reliasmedia.com/articles/41302-debate-retrospective-vs-concurrent-data-collection

Concurrent collection is an activity that occurs while the patient is hospitalized or undergoing active treatment, while retrospective collection occurs after the …

Medical record professionals and the performance of …

https://pubmed.ncbi.nlm.nih.gov/10276719/

Medical record professionals and the performance of concurrent review This month we feature two articles which discuss the performance of medical record review activities …

Utilization management - Case Management Study Guide

https://casemanagementstudyguide.com/ccm-knowledge-domains/healthcare-reimbursement/utilization-management/

Concurrent Review- A method of reviewing patient care and services during a hospital stay to validate the necessity of care and to explore alternatives to inpatient care. It is also a …

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