06/13/2011
Two more hospitals participate in Enhanced Concurrent Review
Legacy Salmon Creek Hospital and Overlake Hospital are our newest Enhanced Concurrent Review partners. We initiated the Enhanced Concurrent Review model last year for select network hospitals. The goal of the program is to better manage health care costs and enhance the quality of care delivered to our members.
Concurrent review evaluates the medical necessity of inpatient care. It starts when a member is admitted to the hospital. Our nurses coordinate with the facility to review medical care and ensure that the right type of care is happening in the right setting. The process focuses on establishing an effective, timely discharge plan and evaluates the member's need for case and disease management referral.
In the past, hospitals were required to notify us when a member was admitted and remained in inpatient care for more than seven days or needed to stay for more days than were certified. The new approach allows for earlier involvement, along with discharge planning and more timely referral to other care management programs that support the member's health and wellness, such as case and disease management. It also promotes a more collaborative approach to conducting concurrent review with our providers.
Below is a complete list of Washington hospitals participating in Enhanced Concurrent Review:
- Legacy Salmon Creek Hospital, Vancouver
- MultiCare Allenmore Hospital, Tacoma
- MultiCare Good Samaritan Hospital, Puyallup
- MultiCare Mary Bridge Hospital, Tacoma
- MultiCare Tacoma General Hospital, Tacoma
- Overlake Hospital, Bellevue
- Providence Sacred Heart Medical Center, Spokane
- Seattle Children's Hospital, Seattle
- St. Joseph Medical Center, Tacoma
- Swedish Medical Center, Ballard Campus, Seattle
- Swedish Medical Center, Cherry Hill Campus, Seattle
- Swedish Medical Center, First Hill Campus, Seattle
- University of Washington Medical Center, Seattle
If you have questions, please contact your Regence Sales representative.
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