Health Insurance External Review

How to Submit an External Review Application

IMPORTANT NOTICE
To avoid delay, you are encouraged to email your application to consumerservices@alaska.gov or fax it to 907-269-7910 rather than mailing it. If you have questions, or would like an option to upload a file larger than 50 MB please call 907-269-7900 and ask for consumer services.

To avoid a delayed or declined application, please review the Guide to External Review.

Application for Patients and Legal Guardians:
Only the patient or parent/legal guardian of a patient may complete the External Review Application Form.

Application for Medical Providers or other Third-Party Representatives All other third-party’s such as medical providers and other adults applying on behalf of a patient must complete the Third-Party External Review Application Form.

Is your application time sensitive?
If appropriate, a physician may certify an Expedited, Experimental/Investigational or an Expedited Experimental/Investigational External Review by completing the Provider Certification Form in combination with the External Review application or the Third-Party Extremal Review Application form.

Complaints and External Review Applications must be submitted by fax (907-269-7910) or email (consumerservices@alaska.gov). If your submission exceeds 15MB, please contact Consumer Services for an alternative.

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For Insurers

• Register in SBS Connect
• Bulletin 18-13
• Bulletin 18-10
• Bulletin 18-05
• Regulations
• Posters

For Independent Review Organizations

• Register in SBS Connect
• IRO License Application, Renewal or Update
• Licensed Independent Review Organizations
  • Alaska Registered Independent Review Organizations
• Approved Accreditation Entities
  • URAC (Utilization Review Accreditation Commission)

Contact Consumer Services

• Phone: 1-800-INSURAK (in-state, outside Anchorage)
• Fax: 907-269-7910