Utilization Review Agent Renewal
IDOI provides renewal requirements of Certificate of Registration for the Utilization Review Agent under IC 27-8-17 and applicable regulation IAC 760 1-46.
The annual license renewal process can be completed electronically at www.sircon.com/indiana or submitted by paper. The following items must be submitted in order to renew as a Utilization Review Agent.
- Application: Each question must be completed in full. If additional space is needed, attach a separate sheet of paper, properly signed.
- $100.00 Renewal Fee: An electronic renewal notice will be sent by email approximately sixty days prior to the renewal date to the email address we have on file through SIRCON.
- Utilization Review Renewal Checklist: Complete only if there have been any changes to previously submitted documentation. Mark the “Located” column on the checklist for all items that have changed and include supporting documentation.
URAC accreditation does not waive any requirement for documentation submission.
The completed application, renewal fee, and any supporting paperwork should be sent to the following address:
Indiana Department of Insurance
Attn: Utilization Review
311 West Washington Street, Ste 300
Indianapolis, IN 46204-2787