In lieu of conducting a prospective, concurrent, or retrospective review under section 1751.81 of the Revised Code, providing a reconsideration under section 1751.82 of the Revised Code, or conducting an internal review under section 1751.83 of the Revised Code, a health insuring corporation may afford an enrollee an opportunity for an external review under section 3922.08 or 3922.10 of the Revised Code. If an external review is conducted pursuant to this section, the health insuring corporation is not required to afford the enrollee an opportunity for any of the reviews that were disregarded pursuant to this section, including the external review that may have resulted from a review that was disregarded pursuant to this section, unless new clinical information is submitted to the health insuring corporation.
Ohio Rev. Code Ann. § 1751.811
Internal and external reviews
Effective: December 26, 2011; Latest Legislation: House Bill 218 - 129th General Assembly
Official source: Ohio Laws & Administrative Rules (Legislative Service Commission). Reproduced from public-domain Ohio statutes; confirm against the official source for the current text. Not legal advice.