Glossary · Claims and appeals
What is an external review?
An external review is a review of a plan's decision to deny coverage or payment by an independent third party not related to the plan. It can be requested after an appeal is denied, or sooner in urgent cases.
Definition and figures from HealthCare.gov glossary, checked October 23, 2026. This page explains the term; it does not recommend a plan.
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External review: the facts
| Item | Fact | Source |
|---|---|---|
| Reviewer | An independent third party | HealthCare.gov glossary: External review |
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What does external review mean in health insurance?
An external review is a review of a plan's decision to deny coverage or payment by an independent third party not related to the plan. It can be requested after an appeal is denied, or sooner in urgent cases.