External review in Louisiana: deadline, cost and how to ask
Louisiana runs its own independent review of denials: External Review (Louisiana Health Plan Independent 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 Louisiana
- Program
External Review (Louisiana Health Plan Independent Review)
- Who runs it
- Louisiana Department of Insurance (Commissioner of Insurance), which randomly assigns an approved independent review organization: Health insurance issuers regulated by LDI (insured individual and group plans)
- Deadline to ask
4 months
You can file a request within 4 months after you receive the notice, regardless of the claim amount.
- The deadline runs from
The date you receive the notice of the adverse determination or final adverse determination
- Do I have to appeal to my plan first?
You usually must finish the insurer's internal appeal first. You do not have to if the insurer has not decided your grievance in writing within 30 days (unless you agreed to a delay), if the insurer waives the requirement, or if it did not follow the appeal rules (minor, harmless errors do not count). If your case is urgent, you can file for an expedited external review at the same time as an expedited internal appeal. Denials made after care was given (retrospective) must go through the full internal appeal first.
- When you can go without a plan answer
30 days after you file your internal appeal
- Cost
The insurer pays the cost of the external review. No fee or other charge may be charged to you.
- What can be reviewed
Denials that involve medical necessity, appropriateness, health care setting, level of care or effectiveness; rescissions (retroactive cancellation of coverage); and denials of experimental or investigational treatment. Only one external review is allowed for the same denial.
- Is the decision final?
The decision is binding on you and the insurer, except for other remedies available under federal or state law. If the reviewer rules for you, the insurer can later deny those services only for nonpayment of premiums or for fraud or material misrepresentation.
- How to ask
Send your request in writing to your insurance company, at the address in its denial notice (expedited requests do not have to be in writing). Include the forms in the notice, including the signed authorization to release your medical records. Within 5 business days the insurer must tell you whether the request is complete and eligible. If it says the request is not eligible, you can ask the Commissioner of Insurance in writing to decide; the Commissioner answers within 5 business days. Once accepted, LDI assigns a reviewer and tells you who it is, and you have 5 business days to send the reviewer more information.
Law: La. R.S. 22:2433-22:2439, 22:2444
- Phone
Write my appeal: free letters
Sources
The official sources for Louisiana are listed on the Louisiana page.