Pennsylvania Insurance Department - Bureau of Managed Care


Please Note

We are a service company that can help you file with the Pennsylvania Insurance Department - Bureau of Managed Care. We are not associated with this nor any other government agency. We offer paid services and software to help you file. You are not required to purchase our service to file - you may file directly with this agency without using our service.


Contact Information

Physical address:
1311 Strawberry Square
Harrisburg, PA 17120

Phone: (717) 787-4192

Web: Home

Licenses

We track the following licenses with the Pennsylvania Insurance Department - Bureau of Managed Care in order to provide compliance services to our clients. As a client, you see this and other Compliance Core™ data in License Manager in-line with your licenses.

A laptop placed on a desk with our License Manager software on display

Pennsylvania Utilization Review Entity Certification

Type of Review:

Medical Utilization Review

Agency:Pennsylvania Insurance Department - Bureau of Managed Care
Law:

40 PA Stat. § 991.2151

Initial Registration

Form:

Certified Review Entity (CRE) Application

Agency Fee:

$1,000 for managed care plan utilization review, $2,000 for utilization review and external grievance appeal reviews.

Required Attachments:

See the application form for a detailed list of required attachments.

Registration Renewal

Form:

Certified Review Entity (CRE) Application (Renewal)

Agency Fee:

$500 for managed care plan utilization review, $1,000 for utilization review and external grievance appeal reviews.

Due:

Triennially by the date of initial registration.

Notes:

Renewals must be submitted at least 60 days prior to the expiration of the certification period.

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