Transparency of independent review organizations

Independent review organizations (IRO) provide consumers with a chance to appeal a denied health insurance claim if they've already been turned down by their health insurer. They are not affiliated with any health insurer and their decisions are final.

Getting denied by your health insurer for something you believe is necessary or confronting a billing dispute can be very stressful. To help, we provide extensive information about your rights and tools to help guide you through the appeals process.

Search IRO decisions

We've improved the transparency of the independent review process with a new database that allows you to search IRO decisions as of Jan. 1, 2016 by:

  • IRO and health insurer involved
  • Outcome
  • Treatment
  • Diagnosis
  • Reason for the appeal

In addition, you can see the credentials of the person reviewing your appeal and the rationale behind their decision.

After Jan. 1, 2017, certification and oversight of all IROs will move from the Department of Health to the insurance commissioner's office.

See also

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