42 CFR 405.803 - Appeals rights
| Cite as | 42 CFR 405.803 |
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33 practice notes
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AMERICAN AMBULANCE SERVICE OF PA. v. Sullivan, Civ. A. No. 87-7746.
...initial decision-maker) undertakes a de novo review of the written record and either affirms or adjusts the original determination. 42 C.F.R. §§ 405.803-405.806. If still disgruntled, and if the amount in controversy is $100.00 or more, the claimant then may request an oral evidentiary hear......
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David v. Heckler, Civ. A. No. 79 C 2813.
...sends the claimant a notice known as the "Explanation of Medicare Benefits" (EOMB) form, together with the allowed payment, if any. 42 C.F.R. § 405.803. The claimant may then request a review of the decision. Review is by a different employee of the carrier than the one who performed the in......
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Fox v. Harris, Civ. A. No. 79-2117.
...B medical insurance program on behalf of beneficiaries or physicians to whom a beneficiary has assigned his claim for payment. 3 See 42 C.F.R. §§ 405.803-.806 4 These compensatory claims are contained in counts one and three through seven. Count two, seeking to enjoin the new peer review pr......
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Almy v. Sebelius, Civil Action No. RDB–08–1245.
...the provision of coverage and payment determinations in accordance with the Medicare statute and agency guidelines. 42 U.S.C. § 1395u; 42 C.F.R. §§ 405.803, 421.200. Claims by DME suppliers are submitted to jurisdiction-specific administrative contractors called DME Medicare Administrative ......
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33 cases
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AMERICAN AMBULANCE SERVICE OF PA. v. Sullivan, Civ. A. No. 87-7746.
...initial decision-maker) undertakes a de novo review of the written record and either affirms or adjusts the original determination. 42 C.F.R. §§ 405.803-405.806. If still disgruntled, and if the amount in controversy is $100.00 or more, the claimant then may request an oral evidentiary hear......
-
David v. Heckler, Civ. A. No. 79 C 2813.
...sends the claimant a notice known as the "Explanation of Medicare Benefits" (EOMB) form, together with the allowed payment, if any. 42 C.F.R. § 405.803. The claimant may then request a review of the decision. Review is by a different employee of the carrier than the one who performed the in......
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Fox v. Harris, Civ. A. No. 79-2117.
...B medical insurance program on behalf of beneficiaries or physicians to whom a beneficiary has assigned his claim for payment. 3 See 42 C.F.R. §§ 405.803-.806 4 These compensatory claims are contained in counts one and three through seven. Count two, seeking to enjoin the new peer review pr......
-
Almy v. Sebelius, Civil Action No. RDB–08–1245.
...the provision of coverage and payment determinations in accordance with the Medicare statute and agency guidelines. 42 U.S.C. § 1395u; 42 C.F.R. §§ 405.803, 421.200. Claims by DME suppliers are submitted to jurisdiction-specific administrative contractors called DME Medicare Administrative ......
Request a trial to view additional results