Utilization Review Agent Initial Registration
The IDOI provides requirements for Certification of Registration for a new Utilization Review Agent under IC 27-8-18 and applicable regulation IAC 760 1-46.
Initial registration for a new Utilization Review Agent can be completed electronically at www.sircon.com/Indiana or submitted by paper. The following items must be submitted in order to register as an Utilization Review Agent:
- Application:Each question must be completed in full. If additional space is needed, attach a separate sheet of paper, properly signed.
- $150 Application Fee
- Utilization Review checklist:Complete the “Located” column on the checklist with the section and page number of your submission where the item can be found. Attach supporting documentation.
URAC accreditation does not waive any requirement for documentation submission.
If registering by paper, the completed application, application fee, and supporting documentation should be sent to the following address:
Indiana Department of Insurance
Attn: Utilization Review
311 West Washington Street, Suite 300
Indianapolis, IN 46204