Potential liability in utilization review.
Increasingly, utilization review activities arising out of the cost containment concerns of third-party payers and the business community are becoming a factor in the health care delivery process. The author focuses on the potential liability of the physician and the utilization review organization when a patient suffers injury following a disagreement about treatment and urges the physician to deliver necessary services according to his or her medical judgments, not the judgement of the utilization review organization.
D003363:Cost Control; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D008318:Malpractice / Q000331:legislation & jurisprudence*; D010817:Physician-Patient Relations; D014481:United States; D014600:Utilization Review / Q000331:legislation & jurisprudence*