Utilization review is best described as?

• A. A method to increase hospital profits regardless of care
• B. An independent audit of patient satisfaction
• C. A written plan to determine appropriate use of resources, medical necessity of services provided, and cost efficiency
• D. A training program for new PTAs

Answer: (C)

Utilization review is a process that ensures the care provided is appropriate and uses resources in a cost-efficient way. It involves evaluating whether services are medically necessary, how resources are being used, and whether the overall plan is cost-effective. The option described fits this idea exactly by outlining a written plan to determine proper resource use, medical necessity of services, and cost efficiency. It isn’t about boosting profits at the expense of care, auditing patient satisfaction, or training staff, which are different concepts. In practice, utilization review helps decide how many therapy sessions are needed, what treatments are appropriate, and when to discharge, all guided by criteria aimed at appropriate and efficient care.