You should submit your request for an external review to your health insurer in writing by mail, fax, or email.[11] You should include any new information and documentation that you did not previously include with your request for an internal appeal. Please sure to note in your request whether you are seeking a standard external review or an expedited external review. You must file your request within 180 days from the date that your insurer sent you the final decision.[12]

If your claim involves a question about your insurance policy but does not involve a medical determination or any medical information, your insurer will send your request to the Ohio Department of Insurance who will conduct the review of your claim.[13] Otherwise, your insurer will send your request to an external review organization.[14]