William is in the hospital recovering from surgery. He has some complications and his course of treatment has varied for the original plan. A representative from his insurance provider has visited the hospital to check on his progress and prognosis. Part of the visit involves creating a discharge plan. This process is known as:
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When a case is ongoing, the insurance company may send a representative to verify that treatment is consistent with the diagnosis and to work toward establishing a discharge plan to minimize cost. This may include suggesting an extended care facility for convalescence. This process in known as concurrent review.
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