Utilization Review (UR)

The process of assessing the delivery of medical services to determine if the care provided is appropriate, medically necessary, and of high quality. UR may include review of appropriateness of admissions, services ordered and provided, length of stay, and discharge practices, both on a concurrent and retrospective basis

See Also: Self-Insured Health Plan; Third-Party Administrator (TPA); Usual and Customary Charge;

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