Review of a patient’s case by one or more physicians using federal guidelines to evaluate another physician in regard to the quality and efficiency of medical care. This is done to discover overutilization or misutilization of a plan’s benefits.
Tag: USA
Peer review committee
See: peer review group.
Peer review group
Several local physicians who come together to solve insurance claim disputes and support ethical medical practices in the community. Sometimes referred to as a peer review committee .
peer review organization (PRO)
See: Quality Improvement Organization (QIO) program.