*The Ohio Department of Insurance is currently unable to expand access to its external review (IRO) processes to health plans beyond those currently subject to the state external review statutes.  Please direct all questions regarding the federal external review process to the Office of Health Plan Standards and Compliance Assistance at (202)-693-8335. 

Health Claim Denial Appeal Information

• Understanding the Health Coverage and External Review Appeals Processes
  A toolkit to help Ohioans understand the process by which they can appeal a health coverage claim denial made by their insurer.
• Annual External Review Outcome Summaries (Patient Protection Act Report)
  Ohio Revised Code Section 3901.82(D), directs the Department of Insurance to compile and annually publish information regarding independent external review outcomes. Below are links to annual reports, summarizing data the Ohio Department of Insurance has collected regarding external reviews.
• 2009
• 2008
• 2007
• 2006
• 2005
• 2004
• 2003
  
• House Bill 125- Advisory Committee on Eligibility and Real Time Claim Adjudication- Final Report (Jan 2009)
  

Independent External Review

For Insurers

• List of Accredited Organizations
• Select an Independent Review Organization (IRO)
• Company Outcome Reporting
  

For IROs

• IRO Outcome Reporting
• Application for Accreditation as an Ohio IRO:
  
  • Nationally Accredited Independent Review Entity
  • Independent Review Entity that is NOT Nationally Accredited