{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6475.17","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6475.17","heading":"Description of external review procedures","body":"A. 1. Each health carrier shall include a description of the\n\nexternal review procedures in or attached to the policy,\n\ncertificate, membership booklet, outline of coverage or other\n\nevidence of coverage it provides to covered persons.\n\n2. The disclosure required by paragraph 1 of this subsection\n\nshall be in a format prescribed by the Insurance Commissioner.\n\nB. The description required under subsection A of this section\n\nshall include a statement that informs the covered person of the\n\nright of the covered person to file a request for an external review\n\nof an adverse determination or final adverse determination with the\n\nCommissioner. The statement shall explain that external review is\n\navailable when the adverse determination or final adverse\n\ndetermination involves an issue of medical necessity,\n\nappropriateness, health care setting, level of care or\n\neffectiveness. The statement shall include the telephone number and\n\naddress of the Commissioner.\n\nC. In addition to subsection B of this section, the statement\n\nshall inform the covered person that, when filing a request for an\n\nexternal review, the covered person will be required to authorize\n\nthe release of any medical records of the covered person that may be\n\nrequired to be reviewed for the purpose of reaching a decision on\n\nthe external review.","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":"89330f834007ccd8b636221479aa71b0d24089a768154d5810b8fbb5a0f9d6af","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6475.16","next":"us-ok/okla.-stat.-tit.-36-36-6475.2"},"notice":"GroundRules: Original legal text. Not legal advice."}