After discussions with DFR leadership, it has been decided that ClaimAid Advocates should use an Authorized Representative (AR) form without a barcode, unless you have printed it from the submitted application and is thus linked to that specific case.  The generic AR form (with barcode) that we had been using was found to be scanning incorrectly.

Effective immediately, please use this AR Form.

Please also be sure you are using these guidelines when completing the AR form:

  • In section 2, the Name of Representative should be “ClaimAid” – not your name.
  •  In the next field, check “Eligibility Assistance Company”.
  • In the Mailing Address section, please put “c/o Advocate Name, Advocate Address”.
  • Check both “Apply” and “On-going” for functions the AR will do.
  • Complete and sign the rest of the form with patient information.

See example here.