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.[6] During an external review an independent third party reviews your insurer’s decision.[7]

Florida participates in the external review process administered by the U.S. Department of Health and Human Services. You can request an external review form by calling (800) 866-6205. You should include any new information or documentation.

Once you complete the form, you can fax it to (888) 866-6190 or mail it to:

MAXIMUS Federal Services
3750 Monroe Avenue, Suite 705
Pittsford, NY 14534.[8]

You must request an exteral review within 60 days from the date that your insurer sent you the final decision.