You should submit your request for an external review to your health insurer within six months from when your insurer sent you its final decision.[17] Your health insurer must provide you with instructions on how to submit your request.[18] You should submit any new information that you did not previously provide to your health insurer with your request.[19]

Once you submit your request for an external review, your health insurer will then send your request to an external review organization for review.[20] Your health insurer will also send you a notice that an external review organization has been assigned to your case and instructions on how and where to send additional information.[21]