Bills and help
Help someone else with their denial
Get permission to act for a parent, partner or child, and what a doctor's office can do for a patient.
Do this today
- Use the tool: Authorized representative helper See what permission you need to act for someone else and build the letter that names you.
- Read: Acting for someone else 5 minute read. You can usually help a parent, partner or adult child with a denial if they give written permission. Here is how to name a representative with plans, Medicare and Medicaid, and what this page does not cover.
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Put this step on My Plan
So you can come back to it, and keep your dates and calls in one place.
In brief
- A plan must let an authorized representative act for the person in a claim or appeal. Get the person's written permission first.
- Plans, Medicare and Medicaid each have their own way to name a representative. Original Medicare uses Form CMS-1696.
- A doctor can act as representative in an urgent case, and the treating doctor can ask Medicare Advantage for a reconsideration after telling the member.
- This page does not cover powers of attorney, guardianship, minors or what to do if the person has died. Ask the plan and a legal aid office.
More guides, tools and letters
More guides, tools, letters 4
Guides
- Acting for someone else
You can usually help a parent, partner or adult child with a denial if they give written permission. Here is how to name a representative with plans, Medicare and Medicaid, and what this page does not cover.
- For clinicians' offices: supporting a patient's appeal
A short guide for doctors and office staff. Learn when to ask for a peer-to-peer call, which letters to write, how to certify urgency, and what the patient needs to file their own appeal.
Tools
- Tool
Authorized representative helper
See what permission you need to act for someone else and build the letter that names you.
Letters and scripts
- Letter or script
Name someone to act for you
A plain written statement naming a family member, friend or advocate to speak and write to your health plan for you about a claim or appeal. It does not replace the plan's own form.
Questions to keep handy
- What exactly was denied, and under which part of the plan?
- What is my deadline, and what is it counted from?
- Where and how do I send my request, and how will I prove it arrived?
- Who decides, and can I ask for a faster decision?
Not what you need? Find a person who can help, or search the whole site.