PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form FIS2361
for the current year.
Form FIS2361 Auto Insurance Utilization Review Insurer Reply to Provider Appeal - Michigan
What Is Form FIS2361?
This is a legal form that was released by the Michigan Department of Insurance and Financial Services - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form FIS2361 Auto Insurance Utilization Review Insurer Reply to Provider Appeal?
A: Form FIS2361 Auto Insurance Utilization Review Insurer Reply to Provider Appeal is a document used in Michigan for insurers to respond to appeals made by healthcare providers regarding auto insurance utilization review decisions.
Q: Who uses Form FIS2361 Auto Insurance Utilization Review Insurer Reply to Provider Appeal?
A: This form is used by insurance companies in Michigan to provide their response to appeals made by healthcare providers.
Q: What is the purpose of Form FIS2361 Auto Insurance Utilization Review Insurer Reply to Provider Appeal?
A: The purpose of this form is to document the insurer's reply to a provider's appeal regarding utilization review decisions made under auto insurance policies.
Q: When should Form FIS2361 Auto Insurance Utilization Review Insurer Reply to Provider Appeal be used?
A: This form should be used when an insurance company in Michigan receives an appeal from a healthcare provider regarding a utilization review decision made under an auto insurance policy.
Q: Is Form FIS2361 Auto Insurance Utilization Review Insurer Reply to Provider Appeal specific to Michigan?
A: Yes, this form is specific to Michigan, as it is used to respond to appeals made under auto insurance policies in the state.
Form Details:
- Released on April 1, 2022;
- The latest edition provided by the Michigan Department of Insurance and Financial Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form FIS2361 by clicking the link below or browse more documents and templates provided by the Michigan Department of Insurance and Financial Services.
