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How to fill out the APPENDIX RR. APPLICATION FOR REGISTRATION AS AN INDEPENDENT REVIEW ORGANIZATION online
Filling out the Appendix RR application can be a straightforward process when guided correctly. This guide provides step-by-step instructions to help you complete the form accurately and efficiently, ensuring that you meet all necessary requirements.
Follow the steps to fill out the application form with ease.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Fill out the 'Type of Entity' section by selecting the appropriate option: Corporation, Partnership, LLC, or Other. Provide the legal name of the applicant accordingly.
- Complete the contact information section, including the legal name of the applicant, state of domicile, and federal EIN. Provide the name and title of a contact person, along with their phone number and email address.
- If your mailing address differs from your business address, provide that information in the corresponding fields.
- Provide the necessary contact information for initiating external reviews, including the email, contact person's name, phone number, mailing address, and website. Also, include a toll-free telephone number and fax number if applicable.
- Read and agree to the applicant attestation and certification statements. Ensure you are aware of the responsibilities and the requirements as outlined in the application.
- Sign the application in the designated areas for the person who completed the application and for an officer, director, or board member. Ensure to print their names and titles, as well as the dates of signing.
- Prepare the required documents: a copy of the most recent certificate from the American Accreditation HealthCare Commission/URAC, a schedule of fees, and a current Certificate of Authority from the Oklahoma Secretary of State.
- Submit the completed application along with the required attachments to the Oklahoma Insurance Department, External Review Program, at the specified address.
Complete your application and submit online today to ensure prompt processing.
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