044-63 Wyo. Code R. §§ 63-6 - Request for External Review
(a) All requests for external review shall be
made in writing to the insurer, on a form approved by the commissioner,
together with a copy and fee of fifteen dollars ($15.00) payable by check or
money order to the Wyoming State Treasurer. For any single claimant, there is
an annual limit on fees of seventy-five dollars ($75.00) per calendar year.
(b) A claimant or the claimant's
authorized representative may make a request for an external review of a denied
claim or final denied claim.
(c) A
claimant or the claimant's authorized representative may submit additional new
information with the request for external review for consideration during the
external review process.
(d) The
request for external review shall be accompanied by a health care professional
certification of medical necessity.
(e) The request for an expedited review shall
be accompanied by a health care professional certification of need for
expedited review.
Notes
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