External review in Indiana: deadline, cost and how to ask
Indiana runs its own independent review of denials: External grievance (independent review). You generally have 120 days 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 Indiana
- Program
External grievance (independent review)
- Who runs it
- Your insurer, which sends the case to an independent review organization certified by the Indiana Department of Insurance: Health insurance policies
- Your HMO, which sends the case to an independent review organization certified by the Indiana Department of Insurance: HMO contracts
- Deadline to ask
120 days
You must file a written request within 120 days after you are told the result of your appeal. You can file only one external grievance about the same appeal decision.
- The deadline runs from
The date you are notified of the insurer's or HMO's decision on your appeal of the grievance
- Do I have to appeal to my plan first?
You must first finish the insurer's or HMO's grievance and appeal process; the external grievance is a review of the appeal decision.
- How long the review takes
Standard: 15 business days
- Cost
You pay nothing. The insurer or HMO pays all costs of the independent review organization.
- What can be reviewed
Denials of a service your doctor proposed because it is not appropriate, not medically necessary, or experimental or investigational (for HMOs, also adverse utilization review decisions), and a decision to rescind (cancel back to the start) your policy or contract.
- Is the decision final?
The independent review organization's decision is binding on the insurer or HMO.
- How to ask
Send a written request for an external grievance review to your insurer or HMO (not to the state), using the address and instructions in your appeal decision letter. The insurer picks a certified independent review organization in rotation. You can get help from a doctor, lawyer, friend or family member, and you can send more information at any time during the review. If you send new information, the insurer may reconsider (within 72 hours for urgent cases, 15 days otherwise) and the review pauses until it does.
Law: IC 27-8-29-12, 27-8-29-13, 27-8-29-14, 27-8-29-15, 27-8-29-16, 27-8-29-17; IC 27-13-10.1-1, 27-13-10.1-2, 27-13-10.1-4, 27-13-10.1-5
- Phone
1-800-622-4461 (IDOI Consumer Services)
Write my appeal: free letters
Sources
The official sources for Indiana are listed on the Indiana page.