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QUESTION IMAGE

a method of controlling health care costs by reviewing the medical nece…

Question

a method of controlling health care costs by reviewing the medical necessity of care is called
○ a. utilization review.
○ b. accreditation.
○ c. preadmission certification.
○ d. quality assurance.

Explanation:

Brief Explanations

Utilization review is a process in healthcare that assesses the medical necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. Accreditation is about an organization meeting certain standards (not directly about reviewing medical necessity for cost - control). Preadmission certification is a type of authorization for admission (a subset of utilization review in some cases but not the overall method). Quality assurance focuses on ensuring the quality of care (not specifically on reviewing medical necessity for cost - control).

Answer:

A. utilization review