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This version of the form is not currently in use and is provided for reference only. Download this version of
Form FIS2376
for the current year.
Form FIS2376 Auto Insurance Utilization Review Provider Attestation - Michigan
What Is Form FIS2376?
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 FIS2376?
A: Form FIS2376 is the Auto Insurance Utilization Review Provider Attestation form in Michigan.
Q: What is its purpose?
A: The purpose of Form FIS2376 is to attest that the utilization review provider complies with specified requirements.
Q: Who needs to fill out this form?
A: Utilization review providers in Michigan are required to fill out this form.
Q: What does the form verify?
A: The form verifies that the utilization review provider complies with applicable certification, accreditation, and registration requirements.
Form Details:
- Released on October 1, 2021;
- 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 FIS2376 by clicking the link below or browse more documents and templates provided by the Michigan Department of Insurance and Financial Services.
