Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.

DUI

D007345 MeSH Browser

CUI

M0011450

Previous indexing

Insurance, Health/utilization (1966-1985); Insurance, Hospitalization/utilization (1966-1985); Utilization Review (1968-1985)

History note

91(86); was see under INSURANCE, HEALTH 1986-90

Public note

91; was see under INSURANCE, HEALTH 1986-90