External review in Mississippi: deadline, cost and how to ask
Mississippi runs its own independent review of denials: Health Care 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 Mississippi
- Program
Health Care External Review
- Who runs it
- Mississippi Insurance Department, Life and Health Actuarial Division (assigns an independent review organization): Health insurance policies and HMO plans regulated by Mississippi, including insured employer plans
- Deadline to ask
4 months
You must file your request with the Mississippi Insurance Department within 4 months after you receive the denial notice from your insurer.
- The deadline runs from
The date you receive the insurer's notice of denial (adverse determination or final adverse determination)
- Do I have to appeal to my plan first?
You normally must finish the insurer's internal grievance process first. You are treated as having finished it if the insurer does not decide your grievance within 30 days. If your condition is urgent, you can ask for an expedited external review at the same time as an expedited internal appeal. The insurer can also agree to waive the internal process. For care already received, you must finish the internal process.
- When you can go without a plan answer
30 days after you file your internal appeal
- How long the review takes
Standard: 45 days; Urgent: 72 hours
- Cost
Your insurer pays the cost of the independent review organization. No filing fee is charged under the state rule.
- What can be reviewed
Denials of a health care service or treatment, or payment for it, that involved a judgment about medical necessity, appropriateness, health care setting, level of care or effectiveness, and experimental or investigational treatment denials (your doctor must certify certain facts). Medicaid, Medicare, and limited-benefit policies (such as dental, vision, disability income or long-term care) are not covered.
- Is the decision final?
The decision is binding on the insurer and on you, except to the extent other remedies are available under state or federal law. You cannot ask for a second external review of the same denial.
- How to ask
Fill out the External Review Request Form, sign it (it includes a release of medical records), and mail it with: a copy of your insurance card, the insurer's letter saying its decision is final (or that it waived the internal process), and a copy of your certificate of coverage or policy booklet. Mail to Office of the Insurance Commissioner, Mississippi Insurance Department, Attn: Life and Health Actuarial Division, P.O. Box 79, Jackson, MS 39205. For an expedited review, your provider fills out the certification page.
Law: 19 Miss. Admin. Code Pt. 3, Ch. 15 (Mississippi Health Carrier External Review Regulation), R. 15.05-15.10, 15.15
- Forms and online request
- Phone
Write my appeal: free letters
Sources
The official sources for Mississippi are listed on the Mississippi page.