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2011 Ohio Revised Code
Title [39] XXXIX INSURANCE
Chapter 3922: ADVERSE BENEFIT DETERMINATIONS
3922.02 [Effective12/26/2011] Request for review of adverse benefit determination.


OH Rev Code § 3922.02 What's This?

(A) A covered person may make a request for an external review of an adverse benefit determination.

(B) All requests for external review shall be made in writing, except when making a request for an expedited review under section 3922.09 of the Revised Code, by the covered person within one hundred eighty days of the date of the final adverse benefit determination in a form prescribed by the superintendent. Requests for an expedited review may be requested orally or by electronic means. When an oral or electronic request for review is made, written confirmation of the request must be submitted to the health plan issuer no later than five days after the initial request was made.

(C) An adverse benefit determination shall be eligible for internal appeal or external review, regardless of how small the cost of the requested health care service related to the adverse benefit determination is.

Added by 129th General Assembly File No. 48, HB 218, § 1, eff. 12/26/2011.

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