Evargas6357
New
Can someone give me some insight on the external review process. My doctor wants me to request an external review from Maximus (Texas). I have exhausted the appeals/reconsideration process with the insurance and now he wants a third party external review submitted. Researched the process but this is something I have never done before and not sure I understand it. The claim was denied for 2 codes bundling to each other, doctor states modifier 59 was appropriate as separate incision sights.