New Hampshire Insurance Department - For Companies, Licensing and Approvals for Prospective Companies, Utilization Review Application

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For Companies > Licensing and Approvals for Prospective Companies > Applications > Utilization Review

Medical Utilization Review Entity Application

The following are the filing requirements to become licensed as a Medical Utilization Review Entity:

Application form
$500.00 application fee (Ins 2001.10). Please make check payable to "Treasurer, State of New Hampshire." The fee is non-refundable.
The entity must have URAC (Utilization Review Accreditation Commission) approval or NCQA (National Committee for Quality Assurance) approval per RSA 420-E:3.
The entity must have a Medical Director licensed in New Hampshire. Contact the Board of Medicine for application at (603) 271-1203.

Please also review:

NHCAR Part Ins 2000 - Medical Utilization Review Entities.
RSA 420-E - Licensure of Medical Review Entities.
RSA 420-J - Managed Care Law.

Send the application to the New Hampshire Insurance Department Financial Examination and Analysis Division.

If you have any questions, please contact Diane Cygan .

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New Hampshire Insurance Department | 21 South Fruit Street, Suite 14 | Concord, NH 03301
Phone 603.271.2261 | Fax 603.271.1406 | Consumer Hotline 1.800.852.3416