Medical Claims Review
Application Requirements for Registration of Medical Claims Review Agent under I.C.27-8-16 et.seq and IAC 760:1-49 are provided by IDOI.
To register as a medical claims review agent, please submit the following. Number each item in the upper right-hand corner to correspond with its number in this Schedule of Requirements.
- Each application question must be completed in full. Attach a separate sheet of paper, properly signed, if additional space is needed.
- Application attachments, which include Medical Claims Review checklist and supporting documentation. Complete the “Located” column on the checklist with section and page number of your submission indicating where the item can be found.
URAC accreditation does not waive any requirement for documentation submission.
- Application fee of $150.
For any questions, contact Rebecca Vaughan at (317) 232-2187 or rvaughan@idoi.in.gov
The completed application and information requested above should be sent to the following:
Indiana Department of Insurance
Attn: Medical Claims Review
311 West Washington Street, Ste 300
Indianapolis, Indiana 46204
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