Can I ask for an External Medical Review?

If you disagree with the DHP internal appeal decision, you have the right to ask for an External Medical Review. An External Medical Review is an optional, extra step you can take to get the case reviewed for free before the State Fair Hearing occurs. You must request the External Medical Review with a State Fair Hearing, it cannot be requested alone. You may name someone to represent you by contacting the health plan and giving the name of the person you want to represent you, or completing the State Fair Hearing and External Medical Review Request Form. You or your representative must ask for an External Medical Review within 120 days of the dateĀ  DHP mails the letter with the internal appeal decision. If you do not ask for a State Fair Hearing with or without External Medical Review within 120 days, you may lose your right to an External Medical Review.

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