External Medical Case Reviews.

If you are physician who start your own healthcare practice External Medical Case Reviews is your chance to get an outside and independent-look at your managed care plan's decision to deny you a health care service. If you want to request an external review you should call or write letter with the request for external review. Then you will get the packet that includes an authorization and a contact sheet. The sheet must be filled out by you, also you can list yourself, your health care provider (with his or her permission), and you can request a particular representative from the insurance company to participate if you wish. Besides any documents that you submit to the External Review Organization will be copied and sent to your insurance carrier. This procedure allows everyone to have the same information when the case is reviewed. Why it’s important? Because now any research that anyone on the panel has that would tend to show that doctors are adopting best practices or refuting undesirable practices.