During an external review, an independent third party reviews your insurer’s decision.[5] Your insurer will no longer have the final say whether to approve a treatment or pay a claim. Under Wisconsin law, you are entitled to request an external review if your insurer denies your coverage after a grievance.[6]

You can also request an expedited external review if your medical situation is urgent and waiting would jeopardize your life or ability to function. You should contact your insurer and ask whether you can also skip the grievance process altogether when requesting an expedited external review.