Which type of review do you need?
- For workers’ compensation and disease-specified plans (like cancer plans), you can ask for a review by an independent review organization (IRO). There are more details below.
- For all other health plans, ask your health plan for an external review. Learn more: How to file an appeal or ask for an external review
How do I file an IRO request?
- Utilization review agents (URAs), payers, insurance companies, and their authorized representatives:
Use the Online IRO Request System. (Instruction manual) - Injured employees, health care providers, or their authorized representatives:
Fill out the request for a review form. (Español)
Rules and regulations
- Health care – 28 Texas Administrative Code 19.1717
- Workers' Compensation Health Care Network and Non-Network: 28 TAC 19.2017 and 28 TAC 133.308
- 28 TAC Chapter 12
Flow charts
- Health care Plans IRO
- Workers Compensation Non Network (WC) IRO
- Workers Compensation Health care Network (WCNet) IRO