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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 FIS2356
for the current year.
Form FIS2356 Auto Insurance Utilization Review Provider Appeal Request - Michigan
What Is Form FIS2356?
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 FIS2356 Auto Insurance Utilization Review Provider Appeal Request?
A: FIS2356 is a form used in Michigan to request an appeal for denial or reduction of auto insurance benefits.
Q: Who can use the FIS2356 form?
A: The FIS2356 form can be used by healthcare providers to appeal decisions made by auto insurance companies regarding benefits.
Q: What is the purpose of the appeal request?
A: The purpose of the appeal request is to challenge the denial or reduction of auto insurance benefits by the insurance company.
Q: How can I submit the FIS2356 form?
A: The FIS2356 form can be submitted to the Michigan Department of Insurance and Financial Services.
Q: What information should be included in the appeal request?
A: The appeal request should include details about the denied or reduced benefits, supporting medical documentation, and any additional information relevant to the case.
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 FIS2356 by clicking the link below or browse more documents and templates provided by the Michigan Department of Insurance and Financial Services.
Download Form FIS2356 Auto Insurance Utilization Review Provider Appeal Request - Michigan
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