Which of the following are not reviewed by a utilization review committee?
A) Physician referrals
B) Cases of emergency department visits and urgent care
C) Individual cases to ensure medical care services are medically necessary
D) Fees for services provided

Question

Quizplus · Accepted Answer

A utilization review committee reviews individual cases to make certain that medical care services are medically necessary (the specificity of diagnosis coding is critical) and to study how providers use medical care resources. This committee also reviews all physician referrals and cases of emergency department visits and urgent care.

Which of the Following Are Not Reviewed by a Utilization