Medicare Scope of Appointment

Per CMS (Medicare) mandated guidelines, all face to face appointments requires the completion of a Scope of Appointment form to be filled out by the beneficiary. Please see below for the Scope of Appointment form. This will serve as a confirmation of our appointment and keep us in line with CMS regulations. You can simply return prior to our appointment by faxing or mailing to our office. Thank You.
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Download Scope of Appointments(Click Carrier Below):
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Use This Example as a Guideline to Fill Out the Scope of Apointment Form:Call for Assistance Over the Phone. Licensed Representatives Waiting 7am-7pm.

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