1. Regulations
  2. title 45
  3. chapter A-i1
  4. part 162
  5. subpart M
  6. § 162.1301

View all text of Subpart M [§ 162.1301 - § 162.1302]

§ 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]

AUTHORITY: 42 U.S.C. 1320d—1320d-9 and secs. 1104 and 10109 of Pub. L. 111-148, 124 Stat. 146-154 and 915-917.

SOURCE: 65 FR 50367, Aug. 17, 2000, unless otherwise noted.

CITE AS: 45 CFR 162.1301