What process involves reviewing inpatient care for medical necessity before admission?

The correct answer is the process of preadmission review, which specifically refers to the evaluation of the necessity of inpatient care before a patient's admission to a hospital or healthcare facility. This process is essential for ensuring that the planned hospitalization is justified and meets established clinical guidelines. By conducting a preadmission review, healthcare providers and insurers can assess whether a patient's condition truly requires inpatient care, potentially leading to more effective utilization of resources and cost containment.

Preadmission reviews help prevent unnecessary admissions, ensuring that patients receive appropriate care based on their medical needs. This process typically involves obtaining relevant clinical information from the provider and may result in the approval or denial of the planned admission based on the criteria outlined by the insurer or healthcare organization.

Utilization review is related but encompasses a broader scope, assessing not just pre-admission scenarios but ongoing care and services provided during a patient's stay. Pre-authorization also pertains to obtaining approval for certain services or procedures before they are performed, but it is specifically focused on the procedural aspect rather than the overall medical necessity of inpatient care prior to admission. Eligibility verification simply determines if a patient’s insurance will cover the services proposed, rather than reviewing the necessity of the care itself. Thus, the most accurate term for the review conducted before