Medicare Claims Processing Manual (Pub. 100-04), Ch. 29 § 270.1

Appointment of Representative - Introduction

Last amended: 2019Year: 2019Length: 227 wordsOfficial source
270.1 - Appointment of Representative - Introduction (Rev. 4380, Issued: 08-30-19, Effective: 07-08-19, Implementation: 10- 01-19) A party may appoint any individual, including an attorney, to act as his/her representative in dealings with the MAC. 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 help the party during the processing of a claim or claims, and/or any subsequent appeal. (See §270.1.8 for details regarding disclosure of individually identifiable beneficiary information.) The appointment of a representative is valid for one year from the date signed by both the party and the appointed representative (see §270.1.5 below). NOTE: • The appointment remains valid for any subsequent levels of appeal on the item/service in question unless the beneficiary specifically withdraws the representative’s authority. • New appeals may be initiated in writing by the representative within the one year timeframe unless the beneficiary provides a written statement of revocation of the representative’s authority. Appeals for other claims may be initiated utilizing an existing appointment instrument within one year of the effective date of the appointment (i.e., the date the appointment instrument is signed by the party and the representative). To initiate a new appeal within the one year timeframe, the representative must file a copy of the completed appointment instrument with the appeal request.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 29 § 270.1: Appointment of Representative - Introduction | Justis AI