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
Examples of utilization review in a Sentence
Recent Examples on the Web
The increase was driven by higher revenues from medical provider networks (MPN), medical bill review, utilization review, and medical case management services.
—
Quartz Intelligence Newsroom, Quartz, 19 Mar. 2025
During the past 15 years, PBMs have expanded their services to include drug utilization reviews, disease management programs and specialty pharmacy services.
—Rita Numerof, Forbes, 16 Dec. 2024
Only one of the 75 had a current version of a utilization review for such powerful drugs.
—Robert T. Garrett, Dallas News, 14 June 2023
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
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Quartz Intelligence Newsroom, Quartz, 19 Mar. 2025
During the past 15 years, PBMs have expanded their services to include drug utilization reviews, disease management programs and specialty pharmacy services.
—Rita Numerof, Forbes, 16 Dec. 2024
Only one of the 75 had a current version of a utilization review for such powerful drugs.
—Robert T. Garrett, Dallas News, 14 June 2023
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
Cite this Entry
“Utilization review.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/utilization%20review. Accessed 30 Apr. 2025.
Copy CitationMedical 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
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