External review in Montana: deadline, cost and how to ask
Montana runs its own independent review of denials: External 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 Montana
- Program
External Review
- Who runs it
- Independent review organizations approved by the Montana Commissioner of Securities and Insurance (assigned by your insurer): Insured health plans regulated in Montana
- Deadline to ask
120 days
You can ask for external review within 120 days after you receive the notice of the denial or the final grievance decision.
- The deadline runs from
The date you receive the notice of the denial (adverse determination) or of the final grievance decision
- Do I have to appeal to my plan first?
Usually you must finish the insurer's grievance process first. You are treated as having finished it if the insurer does not decide your grievance on time (unless you agreed to a delay). You can also ask for an expedited external review at the same time as an expedited grievance if waiting would seriously jeopardize your life or health or your ability to regain maximum function, or for experimental treatment your doctor certifies would be much less effective if not started promptly. You can skip the grievance step if the insurer agrees to waive it.
- Cost
Your insurer pays the cost of the independent review organization. Montana law does not charge you a fee.
- What can be reviewed
Denials of a covered service because the insurer says it does not meet its requirements for medical necessity, appropriateness, health care setting, level of care or effectiveness, and denials of experimental or investigational treatment. If the insurer says your request is not eligible, you can appeal that decision to the Commissioner.
- Is the decision final?
The decision is binding on the insurer. It is binding on you except where you have other remedies under federal or state law. You cannot ask for a second external review of the same denial.
- How to ask
Send a written request to your insurer (an expedited request can be made by phone). The insurer checks within 5 business days that the request is complete and eligible, then assigns an approved independent review organization. You can send extra information to the reviewer in writing within 10 business days after you get the notice that review has started.
Law: Mont. Code Ann. 33-32-404, 33-32-405, 33-32-410, 33-32-411, 33-32-412, 33-32-415, 33-32-422
- Phone
CSI 1-800-332-6148
Write my appeal: free letters
Sources
The official sources for Montana are listed on the Montana page.