PHOENIX
Health Compass
Healthcare decisions deserve clarity, not guesswork.
Skip to content
Phoenix Health Compass logo featuring the Phoenix Compass emblem, symbolizing trusted guidance and resilience.PHOENIXHealth Compass
Phoenix Health CompassAdvocacy Center
All insurance guides

External review

An independent reviewer outside the insurer makes a binding decision.

Timing that matters

Standard external review: about 45 days. Expedited: as fast as 72 hours.

Step by step

  1. 1Available after the internal appeal is exhausted, and immediately in some urgent cases.
  2. 2You usually have four months from the final internal denial to request it.
  3. 3The reviewer's decision is binding on the plan.
  4. 4Your state insurance department or HHS runs the process depending on plan type.
Before you move on

Write down who you spoke with, the date, and what they promised. A short dated note is the single most useful thing you can have if this issue has to be escalated later.

Ask Phoenix about this
Explain external review in simple terms.What should I say when I call?What happens if they say no?

Educational purposes only

Phoenix Health Compass does not provide legal advice or medical advice. This content summarizes publicly available government and nonprofit resources and is cited throughout. Always confirm requirements, deadlines, and forms with the official agency.

Last reviewed by the Phoenix Health Compass editorial team.