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Concurrent Review Authorization Form For Concurrent Review Requests: Fax to 800.575.4429 or call 800.298.4806 to speak with an encore representative. Please provide supporting clinical documentation
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How to fill out for concurrent review requests

01
Contact your insurance provider to determine their specific requirements for concurrent review requests.
02
Gather all relevant medical records, test results, and physician notes for the patient.
03
Complete any necessary forms provided by the insurance company, including demographic information and treatment plans.
04
Submit the completed forms and supporting documentation to the designated address or email provided by the insurance company.
05
Follow up with the insurance company to ensure they have received the request and have all necessary information to make a decision.

Who needs for concurrent review requests?

01
Healthcare providers who are seeking authorization for ongoing medical treatment or procedures for their patients.
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Concurrent review requests are requests for approval or authorization for medical services, treatments, or procedures that must be reviewed at the same time as the patient is receiving care.
Healthcare providers and insurance companies are typically required to file for concurrent review requests.
Concurrent review requests can be filled out by submitting all necessary documentation and information to the appropriate reviewing entity.
The purpose of concurrent review requests is to ensure that medical services, treatments, or procedures are appropriate and necessary for the patient's care.
Information such as the patient's medical history, treatment plan, and supporting documentation must be reported on concurrent review requests.
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