The Aztec Health Plan has a variety of organizational committees related to quality and utilization management. These committees include the medical advisory committee, the credentialing committee, the utilization management committee, and the quality management committee. Of these committees, the one that most likely is responsible for providing oversight of Aztec's inpatient concurrent review process is the:
A) medical advisory committee
B) credentialing committee
C) utilization management committee
D) quality management committee

Question

Quizplus · Accepted Answer

The utilization management committee is responsible for overseeing the utilization of inpatient and outpatient services, including concurrent review. Therefore, it is most likely to be responsible for providing oversight of Aztec's inpatient concurrent review process. The medical advisory committee focuses on clinical matters and providing input on policies and procedures related to medical care. The credentialing committee is responsible for provider credentialing and enrollment. The quality management committee is responsible for monitoring and improving the quality of healthcare services provided by the organization.

The Aztec Health Plan Has a Variety of Organizational Committees