Utilization review

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Utilization Review

Utilization review (pronounced: yoo-til-i-zay-shun ree-vyoo) is a health care concept that refers to the evaluation of the necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities. This process is conducted under the guidelines set by professional standards and regulatory bodies.

Etymology

The term "utilization review" is derived from the English words "utilize" and "review". "Utilize" comes from the late 18th century English, meaning to make use of, and "review" is derived from the Middle English word "reveue", meaning a formal inspection of military or naval force.

Related Terms

  • Medical necessity: A legal concept related to the utilization review that refers to the determination of whether a medical service or procedure is necessary for the patient's health.
  • Health care services: The wide range of medical care and support services provided by health professionals to individuals in need of health care.
  • Health care facilities: Places where health care services are delivered. This includes hospitals, clinics, and long-term care facilities.
  • Professional standards: The guidelines and ethical codes that professionals in a certain field are expected to adhere to.
  • Regulatory bodies: Organizations that oversee and regulate a certain industry or profession to ensure compliance with laws and regulations.

See Also

External links

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