Internal Claims and Appeals and the External Review Process Overview
Guidance for assisters in the individual Federally-facilitated Marketplaces (FFMs) on assisting consumers with understanding the internal claims and appeals and external review processes for private health insurance.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 27, 2021
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.