The Ohio Department of Insurance is currently unable to expand access to its external review (IRO) processes to health plans beyond those currently subject to the state external review statutes. Please direct all questions regarding the federal external review process to the Office of Health Plan Standards and Compliance Assistance at 202-693-8335.
Health Claim Denial Appeal Information
- Understanding the Health Coverage and External Review Appeals Processes
A toolkit to help Ohioans understand the process by which they can appeal a health coverage claim denial made by their insurer.
- Annual External Review Outcome Summaries (Patient Protection Act Report)
Ohio Revised Code Section 3901.82(D), directs the Ohio Department of Insurance to compile and annually publish information regarding independent external review outcomes.
- House Bill 125- Advisory Committee on Eligibility and Real-Time Claim Adjudication- Final Report (Jan 2009)
Independent External Review Information for IROs and Issuers
Information and instruction for issuers and IROs can be found on the Product Regulation and Actuarial Services page in the "Ohio Internal Appeals and External Review Program" section