Question:
what does it mean when your paper work goes to a independent review organization

i hiered obesitylaw to help me over turn an appeal. and the insurance co sent me a letter stating that they are sending my paper work to a independent review organization here in indiana.. what does this mean?? i was denied by the insurance co twice so thats when i hired obesitylaw. to help me . but then i get this letter.. i need help.    — kim88 (posted on October 5, 2004)

October 5, 2004
This means that the insurance company sends your records to a supposedly non biased outside consulting company where your records are reviewed by a professional---usually a Dr in the field that is being dealt with. I had good luck with this, as the reviwer overturned my insurance company's denial. In my case though, I had to be willing to accept the determination of the reviewer, as the determination was deemed to be binding. Reads the details of the paperwork. I also had to pay a $50 fee to the insurance company that was refunded since the decision was in my favor in the end. I would ask the lawyer what he thinks. It can't hurt to have 2 types of assistance in these types of things. Good luck. Oh, I detailed my experience on my profile. Mine was for plastic surgery.
   — Fixnmyself

October 5, 2004
On a positive note, my insurance submits a lot of stuff to an independant review board and they have decided in my favor every time, both for my RNY and TT. It is common practice. You don't want a nonmedical office person making these decisions.
   — **willow**