You should submit your request for an external review to your health insurer within 60 days from the date that your insurer sent you the final decision.[10] You must also send your insurer a check for half of any fee required.[11] The notice of denial from the second level of internal review will include information regarding the fee requirements for an external review.[12] The fee will be refunded to you if the external review agency decides in your favor.[13] You should also include any additional or new information that you did not include with your request for an internal appeal.

Your health insurer must forward your request and supporting documentation to the external review agency within five days of receiving your request for external review.[14]