Utilization Review Licensing in Oklahoma

Utilization review licenses and certificates are typically issued for organizations conducting either medical or workers’ compensation reviews. This guide contains information about utilization review in Oklahoma. For assistance with licensing, please contact us to learn about our software and managed license services.

Oklahoma Medical Case Manager License

Type of Review:	Workers' Compensation Utilization Review
Agency:	Oklahoma Workers Compensation Commission
Fact Checked:	7/26/18

Initial Registration

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Agency:	Oklahoma Workers Compensation Commission
Form:	Medical Case Manager Application
Agency Fee:	$0
Fact Checked:	7/26/18

Registration Renewal

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Agency:	Oklahoma Workers Compensation Commission
Form:	Medical Case Manager Application (Renewal)
Agency Fee:	$0
Due:	Annually
Fact Checked:	7/26/18

Oklahoma Utilization Review Registration

Type of Review:	Medical Utilization Review
Agency:	Oklahoma Insurance Department
Fact Checked:	7/26/18

Initial Registration

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Agency:	Oklahoma Insurance Department
Form:	Utilization Review Certification and/or Registration Application
Filing Method:	Applicants must use the online SERFF system to apply.
Agency Fee:	$500
Notarize:	Required
Fact Checked:	7/26/18

Registration Renewal

More Details

Agency:	Oklahoma Insurance Department
Form:	Utilization Review Certification and/or Registration Annual Renewal Application
Agency Fee:	$500
Due:	Annually
Notarize:	Required
Fact Checked:	7/26/18

Oklahoma Resources

Annual Certificate (Annual Report) Apostille - Authentication Architecture Firm License Articles of Incorporation Articles of Organization Business License Certificate of Authority Certificate of Cancellation Service Certificate of Good Standing / Existence Certificate of Merger Certification - Authentication Change Your Registered Agent

Charitable Gaming License Charitable Gift Annuity Licensing Compliance Charitable Registration Construction License Converting Your Entity Corporation LLC Nonprofit Amendment Dissolve Corporation LLC Nonprofit Employer (Payroll & Withholding Tax) Registration Service Employment Agency Licensing Engineering Firm License Entity Name Reservation Fictitious Name Registration & Renewal

Foreign Corporation Foreign LLC Healthcare and Pharmaceutical Licenses How to Form an LLC How to Incorporate How to Start a Nonprofit Organization Insurance Licensing Licensing Resources Moving Your Company's Domicile to Nonprofit Articles of Incorporation Nonprofit Compliance Obtain Certified Copies

Private Investigator License Real Estate Licensing Registered Agent Service Reinstate Corporation LLC Nonprofit Sales & Use Tax Registration Service Sales Tax Exemption Start a Business Tax Clearance Certificate Tax Exemption Utilization Review Certification / License

Key Terms

Adverse Determination - When a health care plan or utilization review program decides that a medical treatment or service is not necessary.

Concurrent Review - Utilization review that is conducted during a patient’s course of treatment.

External Review - When an independent review organization is consulted to appeal an insurance company’s adverse determination.

Independent Review Organization (IRO) - Unbiased third-parties that conduct utilization review.

Prospective Review - Utilization review that occurs prior to treatment.

Retrospective Review - Utilization review that occurs after treatment and often after payment.

Utilization Review - A system for evaluating the medical necessity, efficiency, and appropriateness of medical services.

Utilization Review Agent (URA) - An entity that conducts utilization review.

Utilization Review Plan - A document of the procedures used during utilization review.

Revised July 26, 2018. Complete data last reviewed July 26, 2018.