UTILIZATION REVIEW (UR) – means the use of a set of formal techniques designed to monitor the use of, or evaluate the medical necessity, appropriateness, efficacy, or efficiency of, health care services, health care procedures or health care settings. Such techniques may include the monitoring of or evaluation of (A) health care services performed or provided in an outpatient setting, (B) the formal process for determining, prior to discharge from a facility, the coordination and management of the care that a patient receives following discharge from a facility, (C) opportunities or requirements to obtain a clinical evaluation by a health care professional other than the one originally making a recommendation for a proposed health care service, (D) coordinated sets of activities conducted for individual patient management of serious, complicated, protracted or other health conditions, or (E) prospective review, concurrent review, retrospective review or certification.

C.G.S. §38a-591a through §38a-591n & Insurance Department Regulations §38a-591-1 through §38a-591-11 – see Title 38a* Insurance

Initial: $6,000.00
Reinstatement: $6,000.00
Renewal: $6,000.00
Note: Change in fee based on CT Public Act 22-84 effective 1/1/23.
No pro-rating, non-refundable application fee. Plus a nominal NIPR application fee

Two (2) years – Renewal Applications are due each October 1^st for a renewal effective January 1^st. The NIPR System is not available to input your renewal until early September.

All applications will renew bi-annually starting effective 01/01/2023 and each odd numbered year thereafter. If you have a new application within the two-year period you will still renew on the 1^st of each odd numbered year.

• Apply by going to National Insurance Producer Registry (NIPR).
• The Utilization Review – Company License Application (CT Specific UR Application) must be completed and attached to the NIPR warehouse.
• Residents – Step by Step Instructions
• Non-Residents – Step by Step Instructions

• Renewal notices are EMAILED about 120 days before the expiration date. The renewal process is the same as the application process.
• Renew by going to National Insurance Producer Registry (NIPR).
• The Utilization Review – Company License Application (CT Specific UR Application) must be completed and attached to the NIPR warehouse. All required policies/procedures and required letters must be in a redlined format from the previously approved versions and must also be added to the NIPR warehouse.
• Residents – Step by Step Instructions
• Non-Residents – Step by Step Instructions

Not Applicable

• Reinstate by going to National Insurance Producer Registry (NIPR).
• The Utilization Review – Company License Application (CT Specific UR Application) must be completed and attached to the NIPR warehouse. All required policies/procedures and required letters must be in a redlined format from the previously approved versions and must also be added to the NIPR warehouse.
• Residents – Step by Step Instructions
• Non-Residents – Step by Step Instructions

Update your License Information (use to update contact name, email, telephone, addresses, unless residency or state of residency changes)

Material changes to policies, letters and criteria which must be reviewed:

Submit the revised redlined policies, letters, clinical cretiria, or other changes by attaching in the NIPR warehouse under ROA (reporting of actions) for review. Submit an email to LHCompliance@ct.gov to advise that a material change has been added in ROA section in the NIPR warehouse.

Search and print a license

Not applicable.

Not applicable.

Cancel License

Attach the request with the company name, NPN, FEIN and the date to terminate into the NIPR warehouse under ROA section. Then submit an email to LHCompliance@ct.gov to advise them that it has been added for processing.