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