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Question 97 - Certified Health Cloud Accredited Professional discussion

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Care Requests seek authorization from a health plan for drugs, services, and admissions. They can also contain request for review, appeals, complaints and grievances. Which Care Request review ensure that a member is getting the right care in timely and cost-effective way?

A.
Disposition Review
Answers
A.
Disposition Review
B.
Concurrent Review
Answers
B.
Concurrent Review
C.
Care Review
Answers
C.
Care Review
D.
Preauthorization Review
Answers
D.
Preauthorization Review
E.
Retrospective Review
Answers
E.
Retrospective Review
Suggested answer: B

Explanation:

Concurrent review is a type of care request review that ensures that a member is getting the right care in a timely and cost-effective way.It involves reviewing the medical necessity and appropriateness of an ongoing service or admission3. Disposition review, care review, preauthorization review, and retrospective review are not the correct terms for this type of review.

asked 23/09/2024
Andres Mauricio Rodriguez
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