External review in Kansas: deadline, cost and how to ask
Kansas runs its own independent review of denials: External Review (Kansas Insurance Department). 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 Kansas
- Program
External Review (Kansas Insurance Department)
- Who runs it
- Kansas Commissioner of Insurance (Kansas Insurance Department), with contracted external review organizations: Insured health plans and HMOs, municipal group-funded pools, and the State of Kansas self-funded employee health plan. Not Medicare, Medicaid or the federal employees plan.
- Deadline to ask
120 days
Send a written request to the Commissioner of Insurance within 120 days of receiving the adverse decision.
- The deadline runs from
Your receipt of the adverse decision from the plan or insurer
- Do I have to appeal to my plan first?
You must finish all internal appeals first, unless you have an emergency medical condition (then an expedited process is used), the insurer has not given a final internal decision within 60 days of your request (unless you asked for the delay), or the insurer did not strictly follow the appeal rules.
- When you can go without a plan answer
60 days after you file your internal appeal
- Cost
You never pay any part of the reviewer's fee. The Commissioner, the insurer or the plan pays it.
- What can be reviewed
Utilization review decisions that a service that would otherwise be covered is or was not medically necessary, or is experimental or investigational, when the decision leaves you owing the provider or is the reason you did not get the care. Not covered: specified-disease, accident-only, dental, vision, disability income, hospital indemnity, long-term care, Medicare supplement and other limited plans, Medicare, Medicaid, the federal employees plan, workers' compensation and auto medical payment coverage. Only one external review is allowed for the same facts within 12 months, and you cannot use both the federal and the state process.
- Is the decision final?
The reviewer's decision is binding on you and the insurer, but either side can ask a district court to review it from the start (de novo). Going to court does not pause the decision about paying for or providing services.
- How to ask
Send a written request to the Commissioner of Insurance (Kansas Insurance Department, Consumer Assistance Division, 1300 SW Arrowhead Rd., Topeka, KS 66604; kdoi.complaints@ks.gov). You, your doctor or provider with your written permission, or your legal representative can file. Include all information you have about the denial, the appeal form, and a signed release so the Department and the reviewer can get your medical records. The Commissioner decides within 10 business days after getting all needed information whether the case qualifies, and tells you and the insurer in writing. The independent reviewer sends its written decision within 30 business days.
Law: K.S.A. 40-22a13, 40-22a14, 40-22a15, 40-22a16
- Phone
Write my appeal: free letters
Sources
The official sources for Kansas are listed on the Kansas page.