You should submit your request for an external review to the New Mexico Office of Superintendent of Insurance (“Office”) within 120 days from when your insurer sent you the most recent decision.^[16]

Information. You can find a copy of the external review request form here. You should include the following information with your request:

• The name, address, and telephone number of the patient;
• The type of complaint;
• Identification number, group number, and name of employer;
• The type of health care plan;
• The name of the insurance company; and
• Summary of your complaint.^[17]

Supporting documents. You should also include the following supporting documents with your request:

• A signed medical records release form (included in the external review form packet);
• Any new information or documentation not included with your request for an internal review.

Submitting the external review. You can submit your request for an external review in the following ways:

• By fax to (505) 827-6341l
• By email to [email protected] (use the subject line “external review request”); or
• By mail to the following address:

Superintendent of Insurance
Attn: Managed Health Care Bureau –
External Review Request
P.O. Box 1689
1120 Paseo de Peralta
Santa Fe, NM 87504-1689^[18]