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External Review Form - Mass - mass

External Review Form - Mass - mass 2025

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The document outlines the process for requesting an independent external review of a health insurance grievance in Massachusetts. It details the necessary patient information, health insurance coverage details, and the steps to authorize the release of medical records for review. The document also includes instructions for expedited reviews in cases posing serious health threats, as well as guidelines for submitting requests and required documentation.

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What is an external review request?

A review of a plans decision to deny coverage for or payment of a service by an independent third-party not related to the plan. If the plan denies an appeal, an external review can be requested.

What is the federal external review program?

The HHS-Administered Federal External Review Process applies to adverse benefit determinations, including those that involve medical judgment (including, but not limited to, those based on the plans or issuers requirements for medical necessity, appropriateness, health care setting, level of care, or effectiveness

What does external review mean?

External review is a process where you may seek an independent review of a health insurance company decision to refuse to pay for or authorize a treatment or service.

How long does an external review take?

Standard external reviews are decided as soon as possible no later than 45 days after the request was received.

What is an external insurance appeal?

If an insurance company upholds its decision to deny payment, the law provides consumers with the right to appeal the decisions to an outside, independent decision-maker, regardless of the type of insurance or state an individual lives in.

What is RBPO?

As a patient of a Risk-Bearing Provider Organization (RBPO) or an Accountable Care Organization (ACO), your health care providers work together to coordinate your health care. If you disagree with a decision by your health care provider you may request an internal appeal.

External Review Form - Mass - mass 2025

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