106 • The assigned IRO will provide written notice of its final external review decision to you and the Plan within 45 calendar days after the IRO receives the request for the external review. • The assigned IRO’s decision notice will contain the following information, unless such information is inconsistent with applicable current law: • A general description of the reason for the request for external review, including information sufficient to identify the claim (including the date or dates of service, the health care provider, the claim amount (if applicable), the diagnosis code and its corresponding meaning, and the treatment code and its corresponding meaning, and the reason for the previous denial); • The date that the IRO received the assignment to conduct the external review and the date of the IRO decision; • References to the evidence or documentation, including the specific coverage provisions and evidence-based standards, considered in reaching its decision; • A discussion of the principal reason(s) for its decision, including the rationale for its decision and any evidence-based standards that were relied on in making its decision; • A statement that the determination is binding except to the extent that other remedies may be available to you or the Plan under applicable state or federal law; • A statement that judicial review may be available to you; and • Current contact information, including phone number, for any applicable office of health insurance consumer assistance or ombudsman established under the Public Health Services Act to assist with external review processes. Expedited External Review of Claims You may request an expedited external review if: • You receive an initial claim denial that involves a medical condition for which the timeframe for completion of a non-expedited internal appeal would seriously jeopardize your life or health, or would jeopardize your ability to regain maximum function, and you have filed a request for an expedited internal appeal; or • You receive a denial from an appeal that involves a medical condition for which the timeframe for completion of a standard external review would seriously jeopardize your life or health or would jeopardize your ability to regain maximum function; or, you receive a denial from an appeal that concerns an admission, availability of care, continued stay, or health care item or service for which you received emergency services, but you have not yet been discharged from a facility. Preliminary Review Immediately upon receipt of the request for expedited external review, the Plan will complete a preliminary review of the request to determine whether the requirements for preliminary review set forth above, in Section 1(a), are met. The Plan will immediately notify you as to whether your request for review meets the preliminary review requirements, and if not, will provide or seek the information described above in Section 1(b). Review by Independent Review Organization Upon determination that a request is eligible for expedited external review following the preliminary review, the Plan will assign an IRO. The Plan will expeditiously provide or transmit to the assigned IRO all necessary documents and information that it considered in denying the claim.