Appointment of Representative

A party may appoint any individual, including an attorney, to act as his/her representative in dealings with the contractor. Although some parties may pursue a claim or an appeal on their own, others will rely upon the assistance and expertise of others. A representative may be appointed at any point in the appeals process. A representative may help the party during the processing of a claim or claims, and/or any subsequent appeal. The appointment of a representative is valid for one year from either (1) the date signed by the party making the appointment, or (2) the date the appointment is accepted by the representative, whichever is later.

NOTE: A representative must sign (see exceptions below for attorney representative) the appointment within 30 calendar days of the party's signature. The appointment remains valid for any subsequent levels of appeal on the claim/service in question unless the beneficiary specifically withdraws the representative's authority. In order for the appointment to be valid, it must be signed and dated by the beneficiary.

The following is a list of the types of individuals who could be appointed to act as representative for a party to an appeal. This list is not exhaustive, and is meant for illustrative purposes only:

• Congressional staff members;
• Family members of a beneficiary;
• Friends or neighbors of a beneficiary;
• Surrogate decision maker for an incapacitated beneficiary;
• Member of a beneficiary advocacy group;
• Member of a provider or supplier advocacy group;
• Attorneys; and
• Physicians or suppliers

Page Last Updated: Friday, 06-Nov-2009 14:04:53 CST