Alaska Level 2 Appeal of Medical Necessity Denial — Request for External Review is a process by which an individual or organization may challenge a denial of coverage for a medical service or supply by their insurance provider. This appeal is completed by submitting a written request to the Alaska Division of Insurance. The request must include the denial letter from the insurance provider, the reasons for the denial, and the reason(s) for the appeal. The division will then forward the request to an independent external review organization, who will review the denial and provide a recommendation to the division. The division will then make a decision based on the recommendation. There are two types of external review: expedited and standard. The expedited review process is completed within seven days, while the standard review process can take up to 45 days.