$79 — one-time
External review (state IRO)
After two internal denials you have the right to a binding independent review. ACA §2719 forces the insurer to comply with the IRO's decision.
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Routes to your state IRO, HHS-IRO, or ERISA-IRO depending on plan type
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Independent external reviews overturn many denials — KFF cites a 64% reversal in one Maryland study (rates vary by state)
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Insurer is legally bound by the decision — no further appeals needed
Free pre-payment review. If your case isn't a candidate for a strong appeal, you pay nothing — we tell you why and what could change that.