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Glossary > Authorized Representative

Authorized Representative

When it comes to healthcare, HIPAA has always played an important role in the field. Among the many benefits it provides for patients and healthcare professionals, HIPAA has always been firm on protecting sensitive patients' information in the health field.

When it comes to health insurance, patients' information is kept as sensitive materials to a certain degree. In order for anyone else to access details about your health care coverage or make any decisions regarding your coverage, it is recommended that the individual gets assigned as your health insurance authorized representative. Someone who can represent you in any matters concerning your health care coverage. Whether speaking with an agent or broker on the phone or in person, an individual cannot be given any information about your health care coverage unless they are an authorized representative.

What Is An Authorized Representative

A health insurance authorized representative is a trusted individual who you select to act on your behalf regarding your health coverage and related matters. This person will then have consent to make decisions on your behalf and ask questions regarding your health insurance. An authorized representative may have access to review your medical information for the purpose of making the right decision for your health coverage, especially when it comes to filling out claims and appeals.

Who Is Eligible

Your health insurance authorized representative can be your spouse, a family member, or a trusted friend. Your authorized representative can also be your doctor or any individual who's already been appointed legally to represent you through power of attorney. Whoever it is that you choose as your representative, this person will be given access to any medical related information concerning you and your health coverage.

Appointing Someone You To Manage Your Healthcare

To appoint someone as your health insurance authorized representative, you must call member services and request a form to be sent out to You. You can also go online to the Medicare's website to find the correct form depending on which state you live in. People who live in certain states may have to use a different website to fill out the form. Ultimately it is best to call member services and have them send the right form to you in order to avoid filling out the wrong one.

Authorized Representative Form

The required form that needs to be filled out for health insurance authorized representative is the authorized representative form. the form is commonly referred to as "appointment of representative" form and is valid for one year from the date it is signed. The authorized representative form must be filled out and signed by both you and the individual you are appointing as the authorized representative.

In some cases further information may be required in order to verify the representative's identity, the individual must then send documents from two lists of approved documents. The signed form must then be mailed out to member services. You can always update the list of representative by adding or removing names from the list. In order to do so, you must complete an additional form.

When You Should Consider An Authorized Representative

An authorized representative is not always needed but it should be highly considered if the individual is mentally impaired or disabled, or if there are any incompetency in language. In these cases, it is highly advised to appoint an authorized representative. Many aging elders tend to have appointed a representative to act on their behalf as they become more independent on their caregivers. For individual who does not speak English but wishes to have their information processed in English, an authorized representative can also be appointed. The health insurance marketplace provides many ways to help those who are in need after all and accommodates their needs the best way possible.