| Request for Review of Adverse Benefit Determination.

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Effective: September 6, 2012

Latest Legislation: House Bill 341 - 129th General Assembly

(A) A covered person may make a request for an external review of an adverse benefit determination.

(B) All requests for external review shall be made in writing, including by electronic means, by the covered person to the health plan issuer within one hundred eighty days of the date of the final adverse benefit determination. However, in the case of an expedited external review under section 3922.09 of the Revised Code, the review may be requested orally.

(C) An adverse benefit determination shall be eligible for internal appeal or external review, regardless of the cost of the requested health care service related to the adverse benefit determination.


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