Find Laws Find Lawyers Free Legal Forms USA State Laws
CFR > Title 45 - Public Welfare > SUBTITLE A—DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER C—ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS (parts 160 to 165) > PART 162—ADMINISTRATIVE REQUIREMENTS > SUBPART M—Referral Certification and Authorization (§162.1301 to §162.1302) > 162.1301—Referral certification and authorization transaction.

CFR

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]
Tips