The purpose of this webpage is to describe the difference between certified and registered URAs.
Certified URA
A Certified URA is a certified entity that conducts utilization review for a health benefit plan or health insurance policy; a payor; or an administrator holding a certificate of authority under TIC Chapter 4201.
What does this mean?
- Application fee is required
- Renewal of certification every two years and renewal fee must be submitted
- Application must be submitted
- Approval of application before utilization review performed
Registered URA
A Registered URA is a licensed insurance company or health maintenance organization that performs utilization review only for its own insureds or enrollees. Registered URAs are required to comply with TIC Chapter 4201 as a condition of licensure.
What does this mean?
- No application fee
- Renewal of registration every two years
- Application and all applicable checklist(s) must be submitted as would an applicant for certification
- Approval of application before utilization review performed
Search for certified and registered utilization agents on the TDI Certified/Registered Utilization Review Agents page.