| LINKMED®
Interface Tutorial:
HL7
ADT
Segments and
Fields |
6.10 IN1-Insurance Segment
The IN1 segment contains
insurance policy coverage information. This information
is used to properly produce insurance invoicing.
|
Seq
|
Element Name
|
Req
|
Len
|
Comments
|
|
1 |
Segment ID (IN1) |
R |
3 |
IN1_1, HL7TEMPLATE Field |
|
2 |
Insurance Plan ID |
R |
60 |
|
|
3 |
Insurance Company ID |
R |
59 |
|
|
4 |
Insurance Company Name |
O |
130 |
|
|
5 |
Insurance Company Address |
O |
106 |
Address1^Address2^ City^State^Zip |
|
6 |
Insurance Co. Contact Person |
O |
48 |
|
|
7 |
Insurance Co. Phone Number |
O |
40 |
|
|
8 |
Group Number |
O |
12 |
|
|
9 |
Group Name |
O |
130 |
|
|
10 |
Insured's Group Emp ID |
O |
12 |
|
|
11 |
Insured's Group Emp Name |
O |
130 |
|
|
12 |
Plan Effective Date |
O |
8 |
YYYYMMDD |
|
13 |
Plan Expiration Date |
O |
8 |
|
|
14 |
Authorization Information |
O |
55 |
|
|
15 |
Plan Type |
O |
3 |
|
|
16 |
Name Of Insured |
O |
48 |
|
|
17 |
Insured's Relationship To Patient |
O |
2 |
|
|
18 |
Insured's Date Of Birth |
O |
8 |
YYYYMMDD |
|
19 |
Insured's Address |
O |
106 |
Address1^Address2^ City^State^Zip |
|
20 |
Assignment Of Benefits |
O |
2 |
|
|
21 |
Coordination Of Benefits |
O |
2 |
|
|
22 |
Coord. Of Ben. Priority |
O |
2 |
|
|
23 |
Notice Of Admission Flag |
O |
2 |
|
|
24 |
Notice Of Admission Date |
O |
8 |
|
|
25 |
Report Of Eligibility Flag |
O |
2 |
|
|
26 |
Report Of Eligibility Date |
O |
8 |
|
|
27 |
Release Information Code |
O |
2 |
|
|
28 |
Pre-Admit Cert (PAC) |
O |
15 |
|
|
29 |
Verification Date/Time |
O |
26 |
|
|
30 |
Verification By |
O |
60 |
|
|
31
|
Type Of Agreement Code |
O
|
2
|
|
|
32
|
Billing Status |
O
|
2
|
|
|
33
|
Lifetime Reserve Days |
O
|
4
|
|
|
34
|
Delay Before L.R. Day |
O
|
4
|
|
|
35
|
Company Plan Code |
O
|
8
|
|
|
36
|
Policy Number |
O
|
15
|
|
|
37
|
Policy Deductible |
O
|
12
|
|
|
38
|
Policy Limit - Amount |
O
|
12
|
|
|
39
|
Policy Limit - Days |
O
|
4
|
|
|
40
|
Room Rate - Semi-Private |
O
|
12
|
|
|
41
|
Room Rate - Private |
O
|
12
|
|
|
42
|
Insured's Employment Status |
O
|
60
|
|
|
43
|
Insured's Sex |
O
|
1
|
F – female, M – male, U – unknown |
|
44
|
Insured's Employer Address |
O
|
106
|
Address1^Address2^ City^State^Zip |
|
45
|
Verification Status |
O
|
2
|
|
|
46
|
Prior Insurance Plan ID |
O
|
8
|
|
|
47
|
Coverage Type |
O
|
3
|
|
|
48
|
Handicap |
O
|
2
|
|
|
49
|
Insured's ID Number |
O
|
12
|
|
|
50
|
SignatureCode |
O
|
1
|
|
|
51
|
SignatureCodeDate |
O
|
20
|
YYYYMMDD |
|
52
|
InsuredBirthPlace |
O
|
250
|
|
|
53
|
VIPIndicatorIN1 |
O
|
20
|
Note:HL7 segment IN2 and IN3 will not be descibed in this tutorial
6.11 ACC-Accident Segment
The ACC
segment contains information about a patient that has been
involved in an accident.
|
Seq
|
Element Name
|
Req
|
Len
|
Comments
|
|
|
0 |
Segment ID (ACC) |
R |
3 |
"ACC" |
|
|
1 |
Accident Date/Time |
O |
12 |
YYYYMMDDhhmm[ss] |
|
|
2 |
Accident Code |
O |
60 |
Accident code^Description |
|
|
3 |
Accident Location |
O |
25 |
Accident Place |
|
|
4 |
Auto Accident State |
O |
60 |
|
|
|
5 |
Accident Job Related Indicator |
O |
2 |
|
|
|
6
|
Accident Death Indicator |
O
|
2
|
||
|
7
|
ACCEnteredBy |
O
|
250
|
||
|
8
|
AccidentDescription |
O
|
25
|
||
|
9
|
BroughtInBy |
O
|
80
|
||
|
10
|
PoliceNotifiedIndicator |
O
|
20
|
||
|
11
|
AccidentAddress |
O
|
250
|
||
|
R = Required, CR = Conditionally Required, O = Optional, N = Numeric, AN = Alpha/Numeric, ID = Segment Identification |
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