Can members have an authorized representative pursue their claim or appeal?
Yes, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) members may have an authorized representative pursue a claim or appeal. The health plan can establish reasonable procedures for determining whether an individual has been authorized to represent a member. In a claim involving urgent care, the plan must permit a health care professional with knowledge of the member's medical condition to be an authorized representative.
Members may designate in writing anyone they want to be their authorized representative. The following people will not need to produce written consent signed by the member in order to be considered the member's authorized representative:
- Family members
- Member's guardian (if not a family member, written proof of guardianship is required)
- Patient's treating physician or other treating health care professional
All others including agents must sign a Designation of Authorized Representative and Release of Information form. These forms may be obtained by writing to BCBSM.
BCN also requires an authorization from its subscribers.