Which review process evaluates coding information after services have been delivered?

The process that evaluates coding information after services have been delivered is known as a retrospective review. In this type of review, the focus is on examining the documentation, coding, and billing practices after the healthcare services have already been provided to patients. This allows organizations to assess the accuracy of coding, adherence to billing requirements, and overall compliance with healthcare regulations.

Retrospective reviews serve several purposes, including identifying patterns that may require further training for coders, ensuring that claims submitted to insurance companies are justified based on the services rendered, and evaluating whether the documentation supports the codes used. They can also identify areas where improvements may be needed, thereby enhancing the overall efficiency and accuracy of future billing processes.

In contrast, concurrent review takes place while the patient is still receiving care, focusing on immediate appropriateness and effectiveness of services. Utilization review encompasses a broader range of activities aimed at evaluating the necessity, appropriateness, and efficiency of healthcare services, often before or during care. Preventive review refers to processes aimed at preventing issues from arising in the first place, such as ensuring that preventive services are offered to patients. Thus, retrospective review is the most accurate choice for evaluating coding information post-service delivery.