You should submit a request for an external review to your insurer by completing an appeals form that your insurer provides to you within four months from the date on the first appeal denial letter.[6] Be sure to inform your insurer on the appeals form whether you are seeking a standard or an expedited external review.

Your insurer will then forward the request to the Delaware Department of Insurance with an email outlining the plan type and the reason for the denial of coverage.[7] The Department will then refer the request to an independent outside review organization. The insurer must submit complete plan information, complete claim information, and all medical records and other documents used to make its decision to the review organization.[8] The reviewer will select three independent medical providers to review the appeal and provide a final decision.[9]