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     Home → Welfare→ SPD → 6.5.5 CONCURRENT (CONTINUED STAY) REVIEW

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6.5.5 CONCURRENT (CONTINUED STAY) REVIEW

When you are receiving medical services in a Hospital or specialized facility, the Utilization Management Organization may contact you to assure that continuation of medical services is Medically Necessary .

Concurrent Review may include such services as:
  • coordinating Home Health Care or the provision of Durable Medical Equipment;
  • determining the Medical Necessity of continued medical services; and/or
  • advising you of the various options covered under this Plan for your medical care.
The Plan pays no benefits for charges related to days of confinement in a Hospital or specialized facility that have not been determined to be Medically Necessary.

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