Medical Claims Review Agent Renewal
The IDOI provides renewal requirements for Certificate of Registration for Medical Claims Review Agent under IC 28-8-16 and applicable regulation IAC 760 1-49.
The annual license renewal process can be completed electronically at www.sircon.com/indiana or submitted by paper. The following items must be submitted in order to renew as a Medical Claims Review Agent.
- Application - Each question must be completed in full. If additional space is needed, attach a separate sheet of paper, properly signed.
- $100 Renewal fee - An electronic renewal notice will be sent by email approximately sixty days prior to the renewal date to the email address on file through SIRCON.
- Medical Claims Review Checklist - Complete only if there have been any changesto the previously submitted documentation. Mark the “Located” column on the checklist for all items that have changed and include supporting documentation.
URAC accreditation does not waive any requirement for documentation submission.
If renewing by paper, the completed application, renewal fee, and any supporting paperwork should be sent to the following address:
Indiana Department of Insurance
Attn: Medical Claims Review
311 West Washington Street, Ste 300
Indianapolis, Indiana 46204-2787