If your insurer denies your claim after a first level appeal or first level grievance, you may (but are not required to) file a second level grievance with your insurer.[5] Your health care provider can submit the request for you.[6] Instructions for filing a second level grievance should have been included in the health insurer’s denial letter from the first level appeal or grievance.[7]

During a second level grievance, the health insurer is required to form a review panel and conduct a hearing, which you can attend either in-person or by phone.[8]The hearing must be held within 45 days from when your insurer receives your second level grievance request.[9]