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Health Insurance External Review

How to Submit an External Review Application

To avoid delay, you are encouraged to fax your application to 907-269-7910 rather than mailing it. If you have questions, 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 ( If your submission exceeds 15MB, please contact Consumer Services for an alternative.

  External Review Process Flow Charts

For Insurers

For Independent Review Organizations

Contact Consumer Services

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