External review in Colorado: deadline, cost and how to ask
Colorado runs its own independent review of denials: Independent External Review. You generally have 4 months to ask for it.
External review means a doctor or reviewer outside your plan decides again. Internal appeal means your plan looks at its own decision again.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Step 2: Outside review in Colorado
- Program
Independent External Review
- Who runs it
- Colorado Division of Insurance, which assigns a certified independent external review entity: Health coverage plans regulated by the Division of Insurance (insured individual and group plans)
- Deadline to ask
4 months
You must ask for external review within 4 months after receiving the denial of your internal appeal. The Division's guide says that if you used the voluntary second-level internal appeal, you have 60 days after that decision.
- The deadline runs from
Your receipt of the notice that your internal appeal was denied
- Do I have to appeal to my plan first?
You must go through at least one level of internal appeal first. If your situation is urgent, you can ask for an expedited external review at the same time as an expedited internal appeal.
- Cost
The insurance company pays the cost of the external review. There is no minimum claim amount.
- What can be reviewed
Denials of a preauthorization for a covered benefit; denials because care is not medically necessary, appropriate, effective or efficient, or not in the right setting or level of care; experimental or investigational treatment (your doctor must certify in writing why it is needed); denials where a doctor shows an exclusion does not apply; drugs no longer available in Colorado because the maker withdrew them; and whether Colorado's out-of-network (surprise billing) protections apply to your care.
- Is the decision final?
The decision is binding on you and the insurance company. A decision in your favor creates a presumption in any later court case that the denial was not appropriate.
- How to ask
Send your request to your insurance company, following the instructions in the internal appeal denial letter. The company contacts the Division of Insurance, which picks the independent review organization, and the company then tells you in writing who it is. You can send new information directly to the reviewer within 5 business days after that notice.
Law: C.R.S. 10-16-113.5
- Phone
303-894-7490; 800-930-3745
Write my appeal: free letters
Sources
The official sources for Colorado are listed on the Colorado page.