What are the licensing requirements to become licensed as a utilization review and private review agent?
The licensing requirements are:
  • Complete a application packet
  • Submit a licensing fee of $1,200 dollars
  • File a copy of certificate of authority from home state, letter of good standing, and copy of articles of incorporation
  • Provide list(s) of toll free number for accessibility
  • Provide number of incoming telephone lines
  • Provide incoming call queue time
  • Submit all materials designed to inform applicable patients of the requirements of the utilization plan

Show All Answers

1. What is utilization review?
2. What is a private review agent?
3. Who is subject to the state’s utilization review laws?
4. Is it required for a private review agent performing utilization review on single-employer, self-insured health plans to obtain a license?
5. Is the license transferable?
6. Where can I find the laws and regulations that govern utilization review and private review agents?
7. What are the licensing requirements to become licensed as a utilization review and private review agent?
8. How often must licensure be renewed?
9. What are the licensure fees (initial and renewal)?
10. When does a utilization review and private review certificate of license expire?
11. Does South Carolina recognize Utilization Review Accreditation Commission (URAC) accreditation?
12. Are there any other requirements of utilization review and private review agents?
13. Where do you file complaints?