Concurrent Utilization Review: Getting It Right (Utilization‪)‬

Concurrent utilization review is required by virtually all Medicare payers. It is an indispensible part of the hospital revenue cycle that is controlled by clinicians. As the leader of the hospital medical management efforts, many physician executives are held accountable for the success or failure (denials) of inpatient concurrent review even though they are not directly involved in managing the process. Having a good understanding of concurrent review will help physician executives identify opportunities to improve a process that can have a profound impact on hospital earnings.