Insurance License Hub

The Hawaii Independent Bill Reviewer license

Independent Bill Reviewer

Reviews and audits billings for medical services under insurance contracts, licensed alongside the adjuster in the same article. It is the only license on this site whose statute names five medical coding credentials and excuses the holder of any one of them from the domicile test, the experience test and the examination together.

Course

None

This license has no pre-licensing course route.

Ways in

2

1 of them skips the state exam.

Exam

$75

Required on some routes and not others.

Every way to qualify

More than one route leads to this license, and which one you take changes what you study and whether you sit the exam. There is no pre-licensing course among them: this license is qualified for by sitting the examination or a designation already held.

  1. Route 1 Pass the examination on experience in reviewing medical billings

    State exam required

    Domicile, which reaches beyond the State

    • Domiciled in Hawaii, or in a state that will permit residents of Hawaii to act as independent bill reviewers in that other state

    and experience, special education or training, with no number on any of the three

    • Experience, special education, or training with reference to the review or audit of billings for medical services under insurance contracts, of sufficient duration and extent to reasonably make the individual competent to fulfill the responsibilities of an independent bill reviewer

    431:9-243 paragraphs (1) to (3), and it is the adjuster's qualification with the subject matter swapped: the same domicile clause, the same competence test with no hours in it, and the same paper under 431:9-206, which names the independent bill reviewer alongside the adjuster. The license has existed since 2000. The nearest thing elsewhere is the utilization review agent, which Connecticut, Nebraska, North Dakota, South Dakota and Tennessee license and Maine registers without licensing, and none of those is the same job: this one reviews the bill rather than the treatment.

    Read at capitol.hawaii.gov on 2026-08-19

  2. Route 2 Hold one of five medical coding credentials

    Exempt from the state exam

    • CPC Certified Professional Coder, from American Academy of Professional Coders

    • or

      RHIA Registered Health Information Administrator, from American Health Information Management Association

    • or

      RHIT Registered Health Information Technician, from American Health Information Management Association

    • or

      CCS Certified Coding Specialist, from American Health Information Management Association

    • or

      CCA Certified Coding Associate, from American Health Information Management Association

    The proviso at the end of 431:9-243 is wider than any other designation waiver on this site. Where a designation elsewhere excuses an applicant from the course, or from the examination, this one excuses them from "the requirements in paragraphs (1) to (3)" together, which is the domicile clause, the experience and the examination. All that survives is paragraph (4), the fee. The five credentials come from two organizations, one of them the American Academy of Professional Coders and four of them the American Health Information Management Association, and neither is an insurance school. Nothing in the survey is sold against them.

    Read at capitol.hawaii.gov on 2026-08-19

No national seller sells a course for this license. No other state on this site licenses a bill reviewer as such, so there is no national product to sell into it, and the five credentials that waive its examination are medical coding credentials awarded by organizations that are not insurance schools.