utilization review

noun

: a critical evaluation (as by a physician or nurse) of health-care services provided to patients that is made especially for the purpose of controlling costs and monitoring quality of care

Example Sentences

Recent Examples on the Web

As a result of that effort, BSWHealth has reduced FTEs in the utilization review department by over 20% while reducing payer denials by the same percentage. —Tom Davenport, Forbes, 14 June 2021

In areas like utilization review, new technology reads medical record documentation in real time and predicts whether a patient should be in inpatient or observation status, ensuring compliance with regulatory and payer requirements. —Tom Davenport, Forbes, 14 June 2021

Just months before Jennifer’s ordeal, the same utilization review company denied a New Hampshire woman an MRI. —Steve Cohen, STAT, 14 Mar. 2021

The rejection came from a UConn Correctional Manged Healthcare panel known as the utilization review committee, or URC, which must approve a wide range of diagnostic tests and preventative treatments before they can be performed. —Josh Kovner, courant.com, 2 Feb. 2018

Word History

First Known Use

1972, in the meaning defined above

Medical Definition

utilization review

noun

uti·​li·​za·​tion re·​view ˌyüt-ᵊl-ə-ˈzā-shən-ri-ˈvyü 

: the critical examination (as by a physician or nurse) of health-care services provided to patients especially for the purpose of controlling costs (as by identifying unnecessary medical procedures) and monitoring the quality of care