[Code of Federal Regulations]
[Title 45, Volume 1]
[Revised as of October 1, 2001]
From the U.S. Government Printing Office via GPO Access
[CITE: 45CFR162.923]
[Page 677-678]
TITLE 45--PUBLIC WELFARE
SUBTITLE A--DEPARTMENT OF HEALTH
AND HUMAN SERVICES
PART 162--ADMINISTRATIVE REQUIREMENTS--Table of Contents
Subpart I--General Provisions for Transactions
Sec. 162.923 Requirements for covered entities.
(a) General rule. Except as otherwise provided in this part, if a
covered entity conducts with another covered entity (or within the same
covered entity), using electronic media, a transaction for which the
Secretary has adopted a standard under this part, the covered entity
must conduct the transaction as a standard transaction.
(b) Exception for direct data entry transactions. A health care
provider electing to use direct data entry offered by a health plan to
conduct a transaction for which a standard has been adopted under this
part must use the applicable data content and data condition
requirements of the standard when conducting the transaction. The health
care provider is not required to use the format requirements of the
standard.
(c) Use of a business associate. A covered entity may use a business
associate, including a health care clearinghouse, to conduct a
transaction covered by this part. If a covered entity chooses to use a
business associate to conduct all or part of a transaction on
[[Page 678]]
behalf of the covered entity, the covered entity must require the
business associate to do the following:
(1) Comply with all applicable requirements of this part.
(2) Require any agent or subcontractor to comply with all applicable
requirements of this part.