Which process involves the insurer overseeing hospital stays to confirm schedule?

• A. Prospective Review
• B. Retrospective Review
• C. Utilization Review
• D. Concurrent Review

Answer: (D)

Concurrent review is the process where the insurer monitors a patient’s hospital stay while they are still admitted to confirm ongoing medical necessity and to coordinate the discharge plan. This happens during the treatment, allowing adjustments to the care or the schedule for discharge if needed. It differs from prospective review, which happens before admission to decide if care is warranted, and retrospective review, which occurs after services to assess whether the care was appropriate. Since the focus is on ongoing oversight and timing of the stay, concurrent review best fits the idea of confirming the schedule for hospital care.