Code of Federal Regulations (Last Updated: July 5, 2024) |
Title 45 - Public Welfare |
Subtitle A - Department of Health and Human Services |
SubChapter C - Administrative Data Standards and Related Requirements |
Part 162 - Administrative Requirements |
Subpart M - Referral Certification and Authorization |
§ 162.1301 - Referral certification and authorization transaction.
Latest version.
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§ 162.1301 Referral certification and authorization transaction.
The referral certification and authorization transaction is any of the following transmissions:
(a) A request from a health care provider to a health plan for the review of health care to obtain an authorization for the health care.
(b) A request from a health care provider to a health plan to obtain authorization for referring an individual to another health care provider.
(c) A response from a health plan to a health care provider to a request described in paragraph (a) or paragraph (b) of this section.
[74 FR 3326, Jan. 16, 2009]