You should file your request for an external review within six months from your insurer’s most recent decision.[19] If your plan is a health maintenance organization (“HMO”), you should file your request with the Minnesota Department of Health. If your health insurer is an insurance company, you should file your request with the Minnesota Department of Commerce.[20] The respective Departments will assign your case to an external review agency who will then notify you and your health insurer of the assignment and their review of your case.[21]

Information. You can find the external review request form for HMO requests here and the request form for an insurance company here. You should include the following information in your request:

  • The name, address, and telephone number of the enrollee;
  • The name of the patient, if different than the enrollee;
  • The enrollee’s identification number;
  • If you are represented by another person, that person’s name, address, telephone number, and relationship to you; and
  • The name and address of your health plan.[22]

Supporting documents. You should also submit any new information or documentation that you did not previously include with your internal review request.[23] Your insurer will also submit documentation related to your appeal.

Filing fee. There is a $25 filing fee for submitting the request which will be refunded if you are successful.[24] If the filing fee would create a financial hardship, you can provide a written statement explaining why the fee would create such a hardship.

Submit for HMO. You can submit your HMO claim request by mail to:

Minnesota Department of Health
Attn: Managed Care Systems Section
P.O. Box 64882
St. Paul, MN 55164-0882[25]

If you are requesting an expedited review, you can make the request by phone to the Department of Health at (651) 201-5100 or (800) 657-3916. If mailing an application for an expedited review would unreasonably delay the review, you should fax the application to (651) 201-5186 or email it to [email protected].

Submit for Insurance Claim. You can submit your insurance company claim request by mail to:

External Review Process
Minnesota Department of Commerce
85 7th Place East
St. Paul, MN 55101[26]

If you are requesting an expedited review, you should fax the application to (651) 539-0105, email it to [email protected], or call the Department of Commerce at (651) 539-1600 or (800) 657-3602.