['Employee Benefits']

['HIPAA privacy and security']

04/17/2026

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Employee Benefits - HIPAA privacy and security

§162.1301 Referral certification and authorization transaction.

RegSense HIPAA privacy and security Employee Benefits CFR Regulations Associate Benefits & Compensation CFR Section Human Resources English Focus Area USA

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, 2016]

['Employee Benefits']

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