Utilization Review Licensing in Nebraska

A nurse holding up a broken patients arm.

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

Nebraska Independent Review Organization Certification

Agency:Nebraska Department of Insurance
Law:

NE Stat. § 44-1312

Foreign Qualification is Prerequisite:No
Exam Required?Not Set
Registered Agent (Special Agency) Required?No

Initial Registration

Instructions:

Licensing Application Guide

Filing Method:

Online

Agency Fee:

$100

Required Attachments:
  • Documentation that the applicant has received approval or accreditation by a nationally recognized private accrediting agency
  • A list of the principal officers of the entity responsible for its operation, management, and control

Registration Renewal

Instructions:

Licensing Renewal Guide

Filing Method:

Online

Agency Fee:

$100

Due:

Biennially by the date of issuance.

Nebraska Utilization Review Agent Certification

Type of Review:

Medical Utilization Review

Agency:Nebraska Department of Insurance
Law:

NE Stat. § 44-5416 et seq.

Foreign Qualification is Prerequisite:Not Set
Exam Required?Not Set
Registered Agent (Special Agency) Required?Not Set

Initial Registration

Form:

Utilization Review Agent Application

Agency Fee:

$300

Notarize:Required
Required Attachments:
  • Documentation that the applicant has received approval or accreditation by the American Accreditation HealthCare Commission/URAC, or a similar organization which has standards for utilization review agents that are substantially similar to the standards of the American Accreditation HealthCare Commission/URAC, and which has been approved by the director
  • A list of the principal officers of the entity responsible for its operation, management, and control

Registration Renewal

Agency Fee:

$100

Due:

Biennially by the date of issuance.

Notes:

There is no form, instead submit a statement describing any changes in information or documentation submitted with the initial application.

Nebraska Resources

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 Energy Licensing Engineering Firm License Entity Name Reservation
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 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 November 20, 2023. Complete data last reviewed February 18, 2021.
Are You Compliant?
Answer just a few questions and our software searches public databases to detect your status and gaps.
Sign Up for Emails
Better Business Bureau logo
Trustwave logo

© 2012 - 2024 Harbor Compliance. All rights reserved.

Harbor Compliance does not provide tax, financial, or legal advice. Use of our services does not create an attorney-client relationship. Harbor Compliance is not acting as your attorney and does not review information you provide to us for legal accuracy or sufficiency. Access to our website is subject to our Terms of Use and Service Agreement.

Terms of Service Privacy Policy Secure Shopping