External Review

External Review

The External Review process allows the covered person or the covered person’s authorized representative to challenge the health care decision of the insurance carrier and have that decision reviewed by an outside party, not affiliated with the carrier. 

Expedited External Review.  If the time frame for conducting a standard external review of the covered person’s appeal would seriously jeopardize the life or health of the covered person or would jeopardize the covered person’s ability to regain maximum function, the covered person or health care provider should contact the Division immediately by telephone (below). 

To obtain information about the external review process, you should contact:

Iowa Insurance Division

601 Locust St. - 4th Floor

Des Moines, IA 50309-3738

Telephone:  515-281-6348

Toll Free:  877-955-1212

Fax:  515-281-3059

iid.marketregulation@iid.iowa.gov

While the administrative rules process for external review continues and until its completion, persons wishing to file a request for an external review of an adverse determination by a health insurance carrier may do so by completing and submitting this form.   

 If you are seeking assistance in filing a request for External Review or completing the External Review Request Form, you may contact the Consumer Assistance Program of the Iowa Insurance Division by calling 515-281-4458 or 877-955-1212.