HL7 IN1 Segment

The IN1 segment contains insurance policy coverage information necessary to produce properly pro‑rated and patient and insurance bills.

IN1 Attributes

The fields in the IN1 segment are as follows:

SEQ LEN DT OPT RP/# ELEMENT NAME
1 4 SI R   Set ID – Patient ID
2 60 CE R   Insurance Plan ID
3 59 CX R Y Insurance Company ID
4 130 XON O Y Insurance Company Name
5 106 XAD O Y Insurance Company Address
6 48 XPN O Y Insurance Co Contact Person
7 40 XTN O Y Insurance Co Phone Number
8 12 ST O   Group Number
9 130 XON O Y Group Name
10 12 CX O Y Insured’s Group Emp ID
11 130 XON O Y Insured’s Group Emp Name
12 8 DT O   Plan Effective Date
13 8 DT O   Plan Expiration Date
14 55 CM O   Authorization Information
15 3 IS O   Plan Type
16 48 XPN O Y Name Of Insured
17 80 CE O   Insured’s Relationship To Patient
18 26 TS O   Insured’s Date Of Birth
19 160 XAD O Y Insured’s Address
20 2 IS O   Assignment Of Benefits
21 2 IS O   Coordination Of Benefits
22 2 ST O   Coord Of Ben. Priority
23 1 ID O   Notice Of Admission Flag
24 8 DT O   Notice Of Admission Date
25 1 IS O   Report Of Eligibility Flag
26 8 DT O   Report Of Eligibility Date
27 2 IS O   Release Information Code
28 15 ST O   Pre-Admit Cert (PAC)
29 26 TS O   Verification Date/Time
30 60 XCN O  Y Verification By
31 2 IS O   Type Of Agreement Code
32 2 IS O   Billing Status
33 4 NM O   Lifetime Reserve Days
34 4 NM O   Delay Before L.R. Day
35 8 IS O   Company Plan Code
36 15 ST O   Policy Number
37 12 CP O   Policy Deductible
38 12 CP O   Policy Limit – Amount
39 4 NM O   Policy Limit – Days
40 12 CP O   Room Rate – Semi-Private
41 12 CP O   Room Rate – Private
42 60 CE R   Insured’s Employment Status
43 1 IS R   Insured’s Sex
44 106 XAD R Y Insured’s Employer’s Address
45 2 ST O   Verification Status
46 8 IS O   Prior Insurance Plan ID
47 3 IS O   Coverage Type
48 2 IS O   Handicap
49 12 CX O  Y Insured’s ID Number

*Note: For the complete HL7 Standard, please go to the HL7 organization website.

In HL7 pipe and hat format, the IN1 segment (shown in red) for an ADT-A01 message would look like this:

MSH|^~\&|AcmeHIS|StJohn|ADT|StJohn|20050518073622||ADT^A01|MSGID20050518073622|P|2.3

EVN|A01

PID|||12001||Jones^John^^^Mr.||19670822|M|||123 West St.^^Denver^CO^80020^USA||(850)555-

0809|||||99345|460-99-2928

PV1||I|Main^802^1||||^Quacker^John|||IP|||||||||1|||||||||||||||||||||||||20050518073622

IN1|1|EPO|80|AETNA US HEALTHCARE|PO BOX 981114^""^EL PASO^TX^79998^""|||1500004000001|AETNA SERVICES INC|19|AETNA US


HEALTHCARE|""|""||2|SOUTAR^RENEE^D|3|19700722|13324 WHITE CEMETERY

RD^""^HANNIBAL^NY^130740000^""|||||||||||||||||124705454||||||1|F|225


GREENFIELD PARKWAY^^LIVERPOOL^NY^13088|185428


IN2|1||124705454||461-1200||||||

 

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