Utilization Review In Health Care

Satisfactory Essays
The procedure of comparing requirements for medical services (“utilization”) to guidelines or principles that are considered suitable for such services, and making a recommendation built on that evaluation. The term "utilization review" mentions to a retrospective review, the evaluation of treatments or services that have already been directed, and evaluation of medical records in comparison with treatment procedures. In the latter case, data retrieved throughout a utilization review can be used as portion of a system that makes the insurance company's rules for a given condition. When producing these documents, insurance companies not only use patient involvements but also review how medical doctor, laboratories and hospitals handle the treatment
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