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How does utilization review work?

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Anonymous

12y ago
Updated: 8/20/2019

The term 'utilization review' is usually used in the medical field. It is a health insurance company's method of reviewing requests for medical treatment and ensuring that the patient's plan covers the specific treatment. The health insurance company will go over the patient's symptoms, diagnosis and lab tests and determine if they are suitable for coverage. If they are declined, they may start an appeals process.

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Wiki User

12y ago

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