Georgia

Regulator: HHS-Administered Federal External Review (MAXIMUS Federal Services)
External review: HHS-administered federal process (MAXIMUS Federal Services); the state does not run its own.
Published reversal rate: Not published by the regulator · source
Notes: Georgia uses HHS-administered federal external review process per CMS classification (KFF 2024 listing). OCI took over Patient Rights to Independent Review Act duties from DCH on 2022-07-01 but does not publish overturn statistics.

Before external review

File the plan's internal appeal first (at least 180 days for ACA-compliant plans; the letter states the date). Ask for the claim file and the criteria the plan applied; both are free on request. Self-funded employer plans use the federal external review and the U.S. Department of Labor, not the state.

More on Georgia: state appeal rights · External Review Index entry · insurer denial rates (HealthCare.gov states).

Verified 2026-09-15. The regulator's site and your denial notice control.