New Jersey Life and Health State Practice Exam

The correct answer is concurrent review. This process takes place while the insured is actively hospitalized and involves the insurer monitoring the patient's hospital stay to ensure that the level of care and services being provided are necessary and appropriate. During concurrent review, the insurer evaluates the ongoing treatment plans and progress to determine if continued hospitalization is justified.

This ongoing evaluation helps control costs while ensuring that patients receive the medical care they need during their hospital stay. By contrasting it with other types of reviews, we can see that prospective review occurs before hospital admission, focusing on pre-authorization and treatment plans, while retrospective review looks at the care and treatment after the fact, assessing whether it was medically necessary after the patient has been discharged. Utilization review is a broader term encompassing various evaluation techniques used by insurers, including concurrent reviews, but does not specifically indicate the monitoring process during hospitalization like concurrent review does.