Alabama Department of Public Health


Please Note

We are a service company that can help you file with the Alabama Department of Public Health. We are not associated with this nor any other government agency. We offer paid services and software to help you file. You are not required to purchase our service to file - you may file directly with this agency without using our service.


Contact Information

Phone: (334) 206-5140
Fax: (334) 206-5219

Web: Home

Licenses

We track the following licenses with the Alabama Department of Public Health in order to provide compliance services to our clients. As a client, you see this and other reference data in License Manager in-line with your licenses.

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Alabama Utilization Review Agent Certification

Type of Review:

Medical Utilization Review

Agency:Alabama Department of Public Health
Law:

AL Code § 27-3A-1 et seq.

Fact Checked:2/18/21

Initial Registration

Form:

Application for Certification as a UR Review Agent, Attachment A, and Policy and Procedure Checklist (if not accredited through URAC).

Agency Fee:

$0 for URAC accredited entities and $1,000 for non-accredited entities.

Notarize:Required
Required Attachments:

URAC Certified Entities:

  • Attach copy of current certificate of accreditation specific to Health Utilization Management Standards with the application
  • Complete Attachment A (Additional UR sites). Complete this item even if there are no additional sites

 

Non-Accredited Entities:

  • A copy of your policies and procedure which support compliance with the §Code of Alabama 27-3A-5
  • A copy of the complaint and appeals procedures for utilization review determinations
  • Attachment A ("Additional UR Sites"). Complete this item even if there are no additional sites. Select "none" if there are no additional sites and submit attachment with application
Fact Checked:2/18/21

Registration Renewal

Form:

Renewal Application for URAC Accredited Agents or Renewal Application for Non-URAC Accredited Agents

Agency Fee:

$0 for URAC accredited entities and $1,000 for non-accredited entities.

Due:

Annually by June 30.

Notarize:Required
Notes:

Separate renewal forms should be filed for each additional physical site other than the location given.

Before you Apply:

URAC Certified Entities:

  • Copy of current URAC accreditation certification or a letter from URAC if accreditation is in process of renewal
  • Attachment A (Additional UR Sites)

 

Non-Accredited Entities:

  • Policy & Procedure Checklist Form
  • A copy of the complaint and appeal process
  • Policy Attestation Statement
  • Attachment A with contact person information for each UR Site
Fact Checked:2/18/21

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