During an external independent review, an independent third party reviews your insurer’s decision.[5] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim.

If your insurer denies your claim after conducting a formal appeal, you can request an external independent review of the insurer’s decision.[6] You must file your written request for an external independent review within four months from the date that your insurer sent you the last decision.[7]