Concurrent care

Why This Topic Matters

Concurrent care denials can occur when multiple physicians treat the same patient during the same admission or on the same day. Understanding the documentation and administrative factors involved can help practices reduce avoidable denials and support claim review when warranted.

Article Sections

1. What concurrent care means

   Introduces the general concept of concurrent care and notes the kinds of services that are not included in the discussion. The section frames the issue for subsequent denial-management guidance.

2. Analyze concurrent care denials and check code selection

   Discusses reviewing denial patterns, coordinating with other physicians, and checking whether claim submission details align with the services billed. It also addresses communication among providers involved in the same patient episode.

3. Build a document defense

   Focuses on supporting claims with documentation and diagnosis selection that reflect the visit and medical necessity. The section describes using records to substantiate the service and its purpose.

4. Update your specialty designation

   Explains the importance of keeping specialty information current in carrier records. It also outlines the kinds of identifying information commonly included in an update request.

5. Appeal concurrent care denials when necessary

   Covers the general elements that may be included in an appeal packet for a concurrent care denial. The section emphasizes supporting materials that help demonstrate the service was medically necessary.