Utilization Review Licensing in Vermont

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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 Vermont. For assistance with licensing, please contact us to learn about our software and managed license services.

Vermont Mental Health Review Agent License

Type of Review:

Medical Utilization Review

Agency:Vermont Department of Financial Regulation
Foreign Qualification is Prerequisite:Not Set
Notes:

Applies only to mental health care review organizations.

Exam Required?Not Set
Registered Agent (Special Agency) Required?Not Set

Initial Registration

Form:

Mental Health Review Agent License Application

Agency Fee:

$200

Registration Renewal

Form:

Renewal Application Form

Agency Fee:

$200

Due:

Annually

Vermont Resources

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Fictitious Name Registration & Renewal Finance Licensing In 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 Information & 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

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.
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