Wyoming Administrative Code
Agency 044 - Insurance Dept
Sub-Agency 0002 - General Agency, Board or Commission Rules
Chapter 63 - MEDICAL NECESSITY REVIEW RIGHTS
Section 63-6 - Request for External Review
Current through September 21, 2024
(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.
