The Independent Medical Review Program

5 The Fourth Step- The review process When your request qualifies as an IMR, the case is then sent to the IMR organization designated by the CDI. The CDI notifies the health insurance company involved and requires them to provide the IMR organization with copies of all documents necessary to conduct the IMR. In most cases, your insurance company must provide all relevant documents including medical records to the IMR organization within three business days. The IMR organization is required to complete its review in writing within 30 days. The Fifth Step - The Determination Once the IMR organization has made its determination, the written determination will be provided to you, to your insurance company, and to the Insurance Commissioner. The determination must contain your medical condition, the important documents reviewed, and the findings that are relevant to your request. The Sixth Step - Implementation Upon receiving the IMR determination, the Insurance Commissioner adopts the recommendation from the IMR organization immediately. A written decision will be issued by the CDI to you and to your insurance company explaining that the recommendation is binding on the insurance company.