An elderly female client was receiving home care after hospitalization for a cerebrovascular accident.After several weeks of physical and speech therapy,the client showed few signs of progress.The utilization review committee considered the client's condition to be stable and declined reimbursement for further home care.Which of the following describes the process that could be used by the client to reverse the decision?

Question

Quizplus · Accepted Answer

A concurrent utilization review is the review of the necessity of services while care is being given.Doing an assessment of the necessity of care before giving service is called a prospective utilization review.A retrospective utilization review is an analysis of the necessity of the services received by the client after the care has been given.This is not an example of the Medicare reversal process.

An Elderly Female Client Was Receiving Home Care After Hospitalization