Utilization Review

Utilization Review is a process used by healthcare providers and insurers to evaluate the necessity, efficiency, and appropriateness of medical services or treatments. Its goal is to ensure that patients receive appropriate care while managing healthcare costs. This review can happen before, during, or after treatment and often involves assessing medical records and treatment plans. By analyzing whether specific services meet established guidelines, Utilization Review helps prevent unnecessary procedures and promotes effective care, ultimately benefiting both patients and the healthcare system.