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Clinical Practice Guidelines Directions for a New Program (1990) / Chapter Skim
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Pages 44-44

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From page 44...
... (Claims review may also include a variety of nonclinical matters, such as whether the general category of service, setting, aIld provider was covered under a patient's benefit plan and whether the service was correctly coded.) As noted earlier, some practice guidelines may translate into or be used as medical review criteria in a straightforward fashion just as some foreign words and phrases for example, caveat emptor are easily used by English speakers)
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Key Terms

  • practice guidelines
  • review criteria
  • clinical practice
  • medical review
  • appropriate care

  • review organizations
  • iom report
  • practice guideline
  • committee definition
  • noted earlier

  • recent iom
  • particular clinical


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