45 C.F.R. § 162.1201 Eligibility for a health plan transaction.
Title 45 - Public Welfare
The eligibility for a health plan transaction is the transmission of either of the following: (a) An inquiry from a health care provider to a health plan, or from one health plan to another health plan, to obtain any of the following information about a benefit plan for an enrollee: (1) Eligibility to receive health care under the health plan. (2) Coverage of health care under the health plan. (3) Benefits associated with the benefit plan. (b) A response from a health plan to a health care provider's (or another health plan's) inquiry described in paragraph (a) of this section.
Title 45: Public Welfare
PART 162—ADMINISTRATIVE REQUIREMENTS
Subpart L—Eligibility for a Health Plan
§ 162.1201 Eligibility for a health plan transaction.
