Last updated: April 24, 2024
Under Wisconsin law, health insurance claimants have a right to an independent review of an insurer's adverse decision of their claim. There is also a similar federal law providing the right to an external review of a decision involving a medical judgment. These reviews are carried out by Independent Review Organizations (IROs) which have no connection to the health plan.
Annually, health plans in Wisconsin are required to submit to OCI information on the independent reviews received during the prior calendar year. Summaries of this information are in included in the Wisconsin Insurance Report.