Concurrent Utilization Review Sample Clauses

The Concurrent Utilization Review clause establishes a process for ongoing assessment of the necessity and appropriateness of healthcare services while they are being provided. Typically, this involves regular reviews by a designated party, such as an insurer or utilization review organization, to determine whether continued hospitalization or treatment is justified based on clinical criteria. By enabling real-time monitoring and decision-making, this clause helps control healthcare costs and ensures that patients receive only medically necessary care, preventing unnecessary or prolonged services.