HL7 Segment : IN1 : Insurance Information

IN1 Fields

  Field   Type  Len  Description
  =====   ====  ===  ===========================================
  IN1-1   SI      4  Set ID - IN1
  IN1-2   CE     60  Insurance Plan ID
  IN1-3   CX     59  Insurance Company ID
  IN1-4   XON   130  Insurance Company Name
  IN1-5   XAD   106  Insurance Company Address
  IN1-6   XPN    48  Insurance Co. Contact Person
  IN1-7   XTN    40  Insurance Co Phone Number
  IN1-8   ST     12  Group Number
  IN1-9   XON   130  Group Name
  IN1-10  CX     12  Insured's Group Emp Name
  IN1-11  XON   130  Insured's Group Emp ID
  IN1-12  DT      8  Plan Effective Date
  IN1-13  DT      8  Plan Expiration Date
  IN1-14  CM     55  Authorization Information
  IN1-15  IS      3  Plan Type
  IN1-16  XPN    48  Name of Insured
  IN1-17  IS      2  Insured's Relationship to Patient
  IN1-18  TS     26  Insured's Date of Birth
  IN1-19  XAD   106  Insured's Address
  IN1-20  IS      2  Assignment of Benefits
  IN1-21  IS      2  Coordination of Benefits
  IN1-22  ST      2  Coord of Ben. Priority
  IN1-23  ID      2  Notice of Admission Flag
  IN1-24  DT      8  Notice of Admission Date
  IN1-25  ID      2  Rpt of Eligibility Flag
  IN1-26  DT      8  Rpt of Eligibility Date
  IN1-27  IS      2  Release Information Code
  IN1-28  ST     15  Pre-Admit Cert (PAC)
  IN1-29  TS     26  Verification Date/Time
  IN1-30  XPN    60  Verification By
  IN1-31  IS      2  Type of Agreement Code
  IN1-32  IS      2  Billing Status
  IN1-33  NM      4  Lifetime Reserve Days
  IN1-34  NM      4  Delay Before L. R. Day
  IN1-35  IS      8  Company Plan Code
  IN1-36  ST     15  Policy Number
  IN1-37  CP     12  Policy Deductible
  IN1-38  CP     12  Policy Limit - Amount
  IN1-39  NM      4  Policy Limit - Days
  IN1-40  CP     12  Room Rate - Semi-Private
  IN1-41  CP     12  Room Rate - Private
  IN1-42  CE     60  Insured's Employment Status
  IN1-43  IS      1  Insured's Sex
  IN1-44  XAD   106  Insured's Employer Address
  IN1-45  ST      2  Verification Status
  IN1-46  IS      8  Prior Insurance Plan ID
  IN1-47  IS      3  Coverage Type
  IN1-48  IS      2  Handicap
  IN1-49  CX     12  Insured's ID Number

Notes