Don’t speak English? We can still help. An interpreter will help translate the conversation.
Fee is waived in cases of financial hardship.
| Name | Fee | Unit |
|---|---|---|
| External Review Request | $25 | per external review ($75 max/year) |
Complete all necessary pages of the OPP external review request form through our secure online form. You will be asked to upload the final adverse determination letter from your health insurance company and any relevant medical records you wish to include.
Please note: At this time OPP may accept mail only through United States Postal Service with no signature of receipt required. Correspondence mailed that requires a signature or uses other delivery services will be returned to sender.
Please mail your completed request form to:
Health Policy Commission
Office of Patient Protection
50 Milk Street, 8th Floor
Boston, MA 02109
You may also submit your completed request form in-person at the address above.
You may also fax your completed request form to 617-624-5046.
OPP cannot accept external review request forms by email. Do not send personal health information or other confidential information to OPP by email.
See here for frequently asked questions (FAQs) about the external review process.
What happens after I submit my external review request form?
You will either receive a letter from OPP stating that your request is eligible for external review or you will receive a letter from OPP stating that your request is ineligible and the reason why it is ineligible.
If your request is eligible, the letter will notify you which external review agency is handling your request. If you want to provide additional documentation or medical records for your appeal, you must send those records to the external review agency directly within 10 days of OPP’s letter. If you have additional information to submit on an expedited external review request, please call OPP.
Don’t speak English? We can still help. An interpreter will help translate the conversation.
