Under certain circumstances, yes. The beneficiary may complete an appointment of representative form (CMS-1696). This form is used to authorize an individual to act as a beneficiary’s representative in connection with a Medicare appeal. 

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 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,
  • Member of a beneficiary advocacy group,
  • Member of a provider or supplier advocacy group,
  • Attorneys, and
  • Physicians or suppliers.

Reference