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utilization review

Utilization review is a technique for controlling medical expenses by reviewing utilization patterns reflected in claims information.

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utilization review

Utilization review is a technique for controlling medical expenses by reviewing utilization patterns reflected in claims information.

Additional Information


Types of, quantities of, and charges for medical services are evaluated to identify problem areas responsible for increasing costs. Specific diagnoses, procedures, service providers, and claimant groups responsible for increasing costs are identified.