8.6k views
1 vote
Prospective utilization review is:

A) Decisions that are being made during the actual course of service such as additional surgery.
B) An evaluation of services once the services have been provided.
C) Examines specific provider patterns of practice.
D) Implemented before the service is actually performed by having the procedure authorized by the MCO.

User Amit Anand
by
7.8k points

1 Answer

3 votes

Answer: Examines specific provider patterns of practice.

Explanation: Prospective reviews provide the original pre-treatment examination and the primary treatment evaluation for a particular area of the body.

Utilization review is a health insurance company's opportunity to review a request for medical treatment. The aim of the examination is to ensure that your healthcare services are covered by the package. It also helps to reduce costs for the client and assess whether the common treatment is appropriate.

Thus, from the above we can conclude that the correct option is C .

User Topxebec
by
8.4k points