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Health Facility Regulation | Hospital and Outpatient Services | Abortion Clinics | Ambulatory Surgery Centers | Birth Centers | Comprehensive Outpatient Rehab. Centers | Crisis Stabilization Units and Short Term Residential Treatment Facilities | Diagnostic Imaging | Hospitals | Partial Hospitalization Programs | Portable X-ray | Rehabilitation Agencies | Residential Treatment Centers for Children and Adolescents | Residential Treatment Facilities | Risk Manager | Rural Health Clinics | Utilization Review

Utilization Review (Private Review Agent)

This program consists of registration of an agent who performs utilization review services for third-party payers on a contractual basis for hospital (outpatient or inpatient) services. The registration process does not include full-time employees, personnel, or staff of health insurers, health maintenance organizations, or hospitals, or wholly owned subsidiaries thereof or affiliates under common ownership, when performing utilization review for their respective hospitals, health maintenance organizations, or insurers of the same insurance group. Agents contracted with the Federal or State government that perform utilization review of medicare or medicaid claims or reviewing workers' compensation claims do not have to be registered under this section. Also, self-insurance funds or service organizations performing reviews of claims pursuant to chapter 440, F.S. or part VII of chapter 626, F.S. are not required to be registered under this section.

Initial/Renewal/Change of Ownership Registration Requirements

All applications for registration must be submitted with a biennial registration fee of $514. There are no survey requirements.

To renew a current state registration that is due to expire, you must print the application for registration form below and submit the completed form(s) with the renewal fee prior to the expiration date of the registration. Renewal applications must be received by the Agency at least 60 days in advance of expiration of a registration or a late fee will be assessed.

Background Screening

Florida Department of Law Enforcement and FBI fingerprinting must be completed by the administrator, managing employee, and any other similarly titled individual who is responsible for the daily operation of the facility. Background screening must be repeated every five years, or sooner if there is a new hire. Please go to the background screening section of this web site for additional documentation that must be submitted with your application.

Statute/Rule Authority

 

Updated March 5, 2009

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Health Facility Regulation | Hospital and Outpatient Services | Abortion Clinics | Ambulatory Surgery Centers | Birth Centers | Comprehensive Outpatient Rehab. Centers | Crisis Stabilization Units and Short Term Residential Treatment Facilities | Diagnostic Imaging | Hospitals | Partial Hospitalization Programs | Portable X-ray | Rehabilitation Agencies | Residential Treatment Centers for Children and Adolescents | Residential Treatment Facilities | Risk Manager | Rural Health Clinics | Utilization Review