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Understanding the Health Claim Denial Appeal and Independent Review Processes

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:

Independent External Review Information for IROs and Issuers:

Information and instruction for issuers and IROs can be found on the Product Regulation and Actuarial Services page in the "Ohio Internal Appeals and External Review Program" section​​​​

Ohio Department of Insurance
50 W. Town Street, Third Floor - Suite 300
Columbus, Ohio  43215
Mike DeWine, Governor | Jillian Froment, Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | Medicare Hotline: 800-686-1578
Health Claims