Utilization Review Licensing in Vermont

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
Notes:

Applies only to mental health care review organizations.

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

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 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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