Procedures for processing reimbursement claims.

CFR · 2024-01-01 · US · Title 10

(a) The Department will conduct a preliminary review of each claim within 60 days after the claim submission deadline announced in the (b) After completing the preliminary review specified in paragraph (a) of this section, the Department may audit, or require the licensee to audit, any documentation used in support of such claim, request the licensee to provide additional information, or request the licensee to provide other clarification determined by the Department to be necessary to complete its evaluation of the claim. In addition, the Department reserves the right to conduct an inspection of the site to verify any information provided by the licensee in a claim for reimbursement, or in support thereof. Any information requested by the Department, if provided, must be submitted by the claimant within 60 days of receipt of the request unless the Department specifies in writing that additional time is provided. (c) At any time during the review of a claim, the Department may request an informal conference with a licensee to obtain further information or clarification on any unresolved issue pertaining to the claim. While the licensee is not required to provide additional clarification requested by the Department, a failure to do so may result in the denial of that portion of the claim for which information is requested. (d) Based upon the claim submitted and any additional information received by the Department, including any audit or site inspection if conducted, the Depar

official document · source cfr-2024 · id 10:§ 765.21