Iowa Admin. Code r. 191-76.4

Current through Register Vol. 47, No. 11, December 11, 2024

Rule 191-76.4 - External review request

(1) Except for requests for expedited review, the covered person or the covered person's authorized representative shall submit a written request for external review (completed Appendix B) to the commissioner by personal delivery, by mail, by fax or by electronic transmission, including a copy of the health carrier's written notice containing the final adverse determination, within the time periods specified in Iowa Code section 514J.107(1) or 514J.109(1), as applicable. The request form and notice shall be submitted to the commissioner at Iowa Insurance Division, 1963 Bell Avenue, Suite 100, Des Moines, Iowa 50315; fax (515)654-6500; or email iid.marketregulation@iid.iowa.gov.

(2) Requests for expedited review may be made orally to initiate the process, and the commissioner may require submission of additional documentation such as physician certifications and medical information releases as is deemed practicable under the time constraints.

(3) There is no charge or fee for submitting a request for external review.

Iowa Admin. Code r. 191-76.4

Adopted by IAB June 22, 2016/Volume XXXVIII, Number 26, effective 7/27/2016

Amended by IAB December 29, 2021/Volume XLIV, Number 13, effective 2/2/2022