{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6475.15","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6475.15","heading":"Written records","body":"A. 1. An independent review organization assigned pursuant to\n\nSection 6475.8, 6475.9, or 6475.10 of this title to conduct an\n\nexternal review shall maintain written records in the aggregate by\n\nstate and by health carrier on all requests for external review for\n\nwhich it conducted an external review during a calendar year and,\n\nupon request, submit a report to the Insurance Commissioner, as\n\nrequired under paragraph 2 of this subsection.\n\n2. Each independent review organization required to maintain\n\nwritten records on all requests for external review pursuant to\n\nparagraph 1 of this subsection for which it was assigned to conduct\n\nan external review shall submit to the Commissioner, upon request, a\n\nreport in the format specified by the Commissioner.\n\n3. The report shall include in the aggregate by state, and for\n\neach health carrier:\n\na. the total number of requests for external review,\n\nb. the number of requests for external review resolved\n\nand, of those resolved, the number resolved upholding\n\nthe adverse determination or final adverse\n\ndetermination and the number resolved reversing the\n\nadverse determination or final adverse determination,\n\nc. the average length of time for resolution,\n\nd. a summary of the types of coverages or cases for which\n\nan external review was sought, as provided in the\n\nformat required by the Commissioner,\n\ne. the number of external reviews pursuant to subsection\n\nG of Section 6475.8 of this title that were terminated\n\nas the result of a reconsideration by the health\n\ncarrier of its adverse determination or final adverse\n\ndetermination after the receipt of additional\n\ninformation from the covered person or the covered\n\nperson's authorized representative, and\n\nf. any other information the Commissioner may request or\n\nrequire.\n\n4. The independent review organization shall retain the written\n\nrecords required pursuant to this subsection for at least three (3)\n\nyears.\n\nB. 1. Each health carrier shall maintain written records in\n\nthe aggregate, by state and for each type of health benefit plan\n\noffered by the health carrier on all requests for external review\n\nthat the health carrier receives notice of from the Commissioner\n\npursuant to this act.\n\n2. Each health carrier required to maintain written records on\n\nall requests for external review pursuant to paragraph 1 of this\n\nsubsection shall submit to the Commissioner, upon request, a report\n\nin the format specified by the Commissioner.\n\n3. The report shall include in the aggregate, by state, and by\n\ntype of health benefit plan:\n\na. the total number of requests for external review,\n\nb. from the total number of requests for external review\n\nreported under subparagraph a of this paragraph, the\n\nnumber of requests determined eligible for a full\n\nexternal review, and\n\nc. any other information the Commissioner may request or\n\nrequire.\n\n4. The health carrier shall retain the written records required\n\npursuant to this subsection for at least three (3) years.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"55f6d45e00b9266f3cabc495a26c4ea9037ce60009ef54da837e7f075907185e","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6475.14","next":"us-ok/okla.-stat.-tit.-36-36-6475.16"},"notice":"GroundRules: Original legal text. Not legal advice."}