View all text of Subpart I [§ 405.900 - § 405.1140]
§ 405.903 - Prepayment review.
(a) A contractor may select a claim(s) for prepayment review.
(b) In conducting a prepayment review, a contractor may issue additional documentation requests to a provider or supplier.
(1) A provider or supplier will be provided 45 calendar days to submit additional documentation in response to a contractor's request, except as stated in paragraph (b)(2) and (c) of this section.
(2) A contractor may accept documentation received after 45-calendar days for good cause. Good cause means situations such as natural disasters, interruptions in business practices, or other extenuating circumstances that the contractor deems good cause in accepting the documentation.
(c) A provider or supplier will be provided 30 calendar days to submit additional documentation in response to a UPIC's request for additional documentation. A UPIC may accept documentation received after the 30 calendar days for good cause. Good cause means situations such as natural disasters, interruptions in business practices, or other extenuating circumstances that the UPIC deems good cause in accepting the documentation.
(d) A contractor's prepayment review will result in an initial determination under § 405.920.