By law only the patient or his/her appointed representative can request a reconsideration (level 2 appeal) or higher level of appeal on a denied Part D drug claim. A physician can become a patient's appointed representative if the CMS-1696 form is completed and signed by the physician and the patient. The Appointment of Representative form is valid for one year. The AOR may be signed before a claim is denied. When a physician elects to serve as an appointed representative, the physician assumes responsibility for managing the appeal, submitting required evidence and paperwork, and keeping the patient informed on the status of the appeal.
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