Get AR Designation Of Authorized Appeal Representative
Arkansas Blue Cross and Blue Shield will accept appeals submitted on your behalf by an authorized appeal representative. In order to properly designate someone else to pursue an appeal on your behalf, Arkansas Blue Cross and Blue Shield requires that you and the person you wish to designate as your Authorized Appeal Representative must each sign this form, indicating that both you and the person you designate as your Authorized Appeal Representative agree to the terms and conditions stated.
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