Appointment Of Representative

As a Touchstone Health plan member, you may appoint any individual (e.g., a friend, relative, lawyer) as your representative to assist you with understanding and following coverage determinations, exceptions, appeals or grievances. To discuss a coverage determination request with someone other than you, we must have authorization to discuss the claim with that person. If you wish to appoint an individual as your representative, please fill out the Appointment of Representative form. The form must be signed, dated and completed by both you and your representative. Please contact Member Services at 1.888.777.0204 (TTY: 1-877-867-5814) for further instructions.