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STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS OFFICE OF FINANCIAL AND INSURANCE REGULATION Before the Commissioner of Financial and Insurance Regulation In the matter of XXXIX Petitioner

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What is request for external review?

A request for external review is a formal request made by an individual or entity to an external review organization to review a decision made by an insurance company or health plan regarding coverage or payment for medical treatment.

Who is required to file request for external review?

Any individual or entity who disagrees with a decision made by an insurance company or health plan regarding coverage or payment for medical treatment may file a request for external review.

How to fill out request for external review?

To fill out a request for external review, the individual or entity will need to provide information such as their personal details, the insurance company or health plan's decision being disputed, details of the medical treatment or service being requested, any supporting documents or medical records, and any other relevant information as required by the external review organization.

What is the purpose of request for external review?

The purpose of a request for external review is to seek an independent evaluation of an insurance company or health plan's decision regarding coverage or payment for medical treatment, in order to resolve any disputes and ensure fair and appropriate coverage.

What information must be reported on request for external review?

The request for external review should include information such as the individual's personal details, the insurance company or health plan's decision being disputed, details of the medical treatment or service being requested, any supporting documents or medical records, and any other relevant information as required by the external review organization.

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