Utilization Review Licensing in Nebraska

Independent Review Organization Application

$100

• 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

Independent Review Organization Application (Renewal)

$100

Biennially by the date of issuance.

Utilization Review Agent Application

$300

• 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

$100

Biennially by the date of issuance.

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