§405.920. Initial determinations.
42 C.F.R. § 405.920
After a claim is filed with the appropriate contractor in the manner and form described in subpart C of part 424 of this chapter, the contractor must—
Determine if the items and services furnished are covered or otherwise reimbursable under title XVIII of the Act;
Determine any amounts payable and make payment accordingly; and
Notify the parties to the initial determination of the determination in accordance with § 405.921.
Notes, amendments, and revision history
Source
Source: 70 FR 11472, Mar. 8, 2005, unless otherwise noted.
Authority
Authority: 42 U.S.C. 263a, 405(a), 1302, 1320b-12, 1395x, 1395y(a), 1395ff, 1395hh, 1395kk, 1395rr, and 1395ww(k).