42 CFR 424.37 – Evidence of authority to sign on behalf of the beneficiary
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(a) Beneficiary incapable. When a party specified in § 424.36(b) signs a claim or request for payment statement, he or she must also submit a brief statement that—
(1) Describes his or her relationship to the beneficiary; and
(2) Explains the circumstances that make it impractical for the beneficiary to sign the claim or statement.
(b) Beneficiary not present for services. When a representative of the provider, nonparticipating hospital, or supplier signs a claim or request for payment statement under § 424.36(c), he or she must explain why it was not possible to obtain the beneficiary’s signature. (For example: “Patient not physically present for test.”)