Medical Peer Review Law and Legal Definition
A medical peer review is scrutiny by one's peers or equals. It aims to raise the quality of care, reduce costs, avoid expensive litigation, enhance hospital reputation, and protect accreditation. A negative peer review determination can result in discipline of a doctor or physician and possible loss of credentials, suspension, or revocation of hospital privileges.
Some of the issues that may be examinied in a per review, among others, include:
- Medical Necessity of completed or proposed procedures
- Pre-Existing Conditions
- Length of Stay
- UCR Fees by geographic location
