To request an external review, you should complete the following steps:

Complete request form. Your insurer should have provided you with the external review request form when it sent you the final adverse determination letter.[6] You should complete that form and submit it to your health insurer per the instructions included with the final adverse determination letter. You should also send any new information and documentation that you had not previously included with your request for an internal appeal.

Deadline. While there is no deadline to request an external review, you should file your request as soon as possible after you receive your determination letter.[7]

Next steps. Your health insurer will send the request to the Texas Department of Insurance (“Department”), which will assign your claim to an independent review organization.[8]