Which of the following statements best describes utilization review?

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Prepare for the MindTap Medical Administrative Assistant Test. Use flashcards and multiple choice questions with hints and explanations. Enhance your readiness for the exam!

Utilization review is primarily focused on evaluating the quality and appropriateness of care that patients receive. The purpose of this process is to ensure that medical services provided to patients are necessary, effective, and appropriate based on established guidelines and standards. By assessing various aspects such as the necessity of certain procedures or treatments, utilization review plays a key role in managing healthcare costs while ensuring that patients receive the best possible care.

This option aligns perfectly with the definition and intent behind utilization review practices, which often involve reviewing services before they are delivered (prospective review) or analyzing services that have already been provided (retrospective review) to ensure they meet required standards. Thus, option C captures the essence of what utilization review entails and why it is important in healthcare settings.

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