During an external review, an independent third party reviews your insurer’s decision.[4] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. Under Wyoming law, you are entitled to request an external review if your insurer denied your coverage after an internal appeal and the denial was based on lack of medical necessity.[5]

You are also entitled to an expedited external review in circumstances where a delay of 45 days would jeopardize your life, health, or ability to regain function or if your claim concerns a request for an admission, availability of care, or continued stay or services for which you received emergency services but have not been discharged from a health care facility.[6] You can request an expedited external review at the same time that you file for an expedited internal review.[7]