Which of the following terms describes the evaluation of the necessity of healthcare services?

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The evaluation of the necessity of healthcare services is best described by the term "utilization review." This process involves assessing the appropriateness and necessity of healthcare services provided to patients, often to ensure that the services being rendered are relevant to the patient's condition and adhere to established treatment protocols. Utilization reviews typically analyze factors like medical necessity, the patient's history, and evidence-based guidelines to determine whether care is justified.

This is distinct from cost-benefit analysis, which primarily focuses on the economic aspects of services rather than their medical necessity. Claim assessment relates to reviewing submitted claims for payment but does not inherently evaluate whether the services were necessary or appropriate for the patient's treatment. Service approval generally indicates a formal process by which specific healthcare services are authorized but again does not specifically address the evaluation of necessity in the same way that utilization review does. Thus, utilization review is the most accurate term for evaluating the necessity of healthcare services.

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