Commission for Case Manager Certification (CCMC) Practice Exam

Concurrent review serves the critical purpose of assessing a patient's ongoing need for medical services while those services are actively being provided. This process allows case managers and healthcare providers to evaluate whether the patient continues to meet specific criteria established for care, such as appropriateness, intensity, and duration of services. By performing this review during the active treatment phase, healthcare professionals can determine if the care plan should be adjusted, extended, or if it can be safely terminated, thereby ensuring that resources are being utilized effectively and that patients are receiving the optimal level of care throughout their treatment journey.

This approach contrasts with retrospective reviews, which focus on past services and outcomes, and evaluations that may center solely on cost analysis or transitions out of care, highlighting the unique focus and importance of concurrent review in patient management.