If your insurer still denies you coverage after you requested an internal appeal or if your situation is urgent, you can request an external review of the insurer’s decision.^[5] During an external review, an independent third party reviews your insurer’s decision.^[6]

Alabama participates in the external review process administered by the U.S. Department of Health and Human Services. You can obtain an external review request form by calling (800) 866-6205 and, once complete, you can fax it to (888) 866-6190 or mail the completed form to:

MAXIMUS Federal Services
3750 Monroe Avenue, Suite 705
Pittsford, NY 14534.^[7]

You must file your written request for an external review within 60 days from the date that your insurer sent you the final decision.