How to Obtain an Independent Review

You, your representative, or your provider may request an independent review. Only you or your legal guardian, however, may sign a medical records release form allowing the IRO to access documents relevant to the review.

The first step is to secure an appeal and independent review request form from your health care plan. Your plan must provide the form if it is required to participate in the IRO process and it denied a treatment because it regarded the treatment as medically unnecessary or inappropriate. You can bypass the appeal process if you or your doctor believes your condition is life threatening.

Note: Your health care plan or its URA must give you the independent review request form again after denying an appeal. If you want an independent review, complete the form and return it to the health plan or URA.