What is the primary role of a Peer Review Organization (PRO)?

The primary role of a Peer Review Organization (PRO) is to review cases for appropriateness and quality of care. PROs are established to ensure that healthcare services are provided according to accepted standards and best practices. They evaluate the necessity and quality of medical services being delivered, which helps in identifying areas for improvement and ensuring that patients receive effective and efficient care. This oversight plays a crucial role in maintaining healthcare standards and enhancing the quality of patient outcomes.

The other options describe functions that do not align with the primary duties of a PRO. Providing direct patient care involves healthcare providers, while billing patients pertains to the administrative side of healthcare services. Managing healthcare fraud investigations is related to compliance and regulatory activities, which is distinct from the quality assessment role of a PRO. Therefore, focusing on evaluating care quality is what defines the core mission of Peer Review Organizations.