During an external review, an independent third party reviews your insurer’s decision.[13] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. Under New Mexico law, you are entitled to request an external review if your insurer denies your coverage after the internal review process.[14]

You can also request an expedited external review if your medical situation is urgent and waiting would jeopardize your health, life, or ability to function. You can also request an expedited external review at the same time that you request an expedited internal review.[15]