It is possible for customers and patients in the hospital to get a treatment or hospitalization in the medical facility without any pre-approval. In this case the concurrent review is non-conclusive in its results. Therefore it can be sufficiently said that the mentioned weaknesses of the concurrent utilization review can hamper and alter the results of the concurrent utilization review. Moreover the clinical ratings that were used in the utilization review had an inter rater reliability of zero and the reduced utilization levels did not depict any evidence of standards or safety.
There are methods and procedures through which it is possible for the medical facilities and hospitals to over go and reduce the weaknesses of the concurrent utilization review to the point of elimination by simply making change to the review process. The issue or the weakness pertaining to the processing of the utilization review while the hospital is active can be resolved by establishing an observatory or a display room, or even through use of high end technology of queue and registration based management information systems. These monitoring facilities and tools can enable the concurrent utilization review process to be isolated from the patient processing and treatment5s which will make the results of the concurrent utilization review more accurate as well. The issue of the pre-approval mandate for the concurrent utilization review can be resolved by simply making use of the retrospective review for utilization instead.
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