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
330, Maple Street
Des Moines, IA 50319
Toll Free: 877-955-1212
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.