_______________________ is "the evaluation of the medical necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilitates these under the provisions of the applicable health benefits plan."
A) Case management
B) Clinical documentation improvement
C) Utilization management
D) Prior-authorization

Question

Quizplus · Accepted Answer

Utilization management is the process of evaluating the medical necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. This is done to ensure that patients receive the right care at the right time while minimizing waste and optimizing cost-effectiveness under their health benefits plan.

_______________________ Is "The Evaluation of the Medical Necessity, Appropriateness, and Efficiency