Utilization Management
/ˌjuːtəlaɪˈzeɪʃən ˈmænɪdʒmənt/
Definitions
- (n.) A process in health law whereby insurers evaluate the necessity, appropriateness, and efficiency of healthcare services before approving payment.
Utilization management helps control healthcare costs by assessing which treatments are medically necessary.
Forms
- utilization management
Related terms
See also
Commentary
Often used in insurance and health law contexts, utilization management requires clear procedural standards to avoid disputes about coverage and reimbursement eligibility.
This glossary is for general informational and educational purposes only. Definitions are jurisdiction-agnostic but reflect terminology and concepts primarily drawn from English and American legal traditions. Nothing herein constitutes legal advice or creates a lawyer-client relationship. Users should consult qualified counsel for advice on specific matters or jurisdictions.