Request an External Review of a Health Insurance Decision
If your health insurance company recently denied your internal appeal, you may request an external review of that decision.
The Office of Patient Protection (OPP) administers an external review process where decisions by your health insurance company, based on medical necessity, can be reviewed by an independent doctor or health care professional.
You have 4 months from receipt of a final adverse determination letter from your health insurance company to request an external review. If your request for an external review is eligible for this process, you will receive a final and binding decision from the external reviewer.
