Concurrent Review
Ongoing evaluation of treatment necessity and appropriateness conducted during active addiction treatment episodes.
Full Definition
Concurrent review is a utilization management process that involves ongoing assessment of treatment necessity, appropriateness, and effectiveness while a patient is actively receiving addiction treatment services. This process ensures that care continues to meet established criteria for the current level of care and identifies when transitions to different treatment intensities may be warranted. Concurrent review requires regular documentation of clinical progress, treatment plan modifications, and continued stay criteria. The review process must demonstrate medical necessity and optimal resource utilization while maintaining therapeutic continuity.
Usage
Usage note: Do not hyphenate; maintain as two words even when used as modifier.
In Context
- "Concurrent review documentation supported the patient's continued need for intensive outpatient services." — Insurance authorization request
- "The treatment team conducts concurrent review weekly to ensure appropriate level of care placement." — Quality assurance protocol