ADT - Insurance

This is a detailed breakdown of the IN1 segment of the ADT HL7 message.

Field Name
Description
Location
Format
Required

Type ID

This is a hospital code that identifies of the insurance is self pay, primary, etc

IN1.1.1

string

Plan ID

A code the insurance company uses to identify the plan

IN1.2.1

string

Plan Name

The name of the plan

IN1.2.2

string

Company ID

A code of the insurance company

IN1.3.1

string

Company Name

The insurance company name

IN1.4.1

string

Company Address - Street

The insurance company street address

IN1.5.1

string

Company Address - Line 2

The insurance company address line 2 (ex PO Box)

IN1.5.2

string

Company Address - City

The insurance company city

IN1.5.3

string

Company Address - Province

The insurance company state or province

IN1.5.4

string

Company Address - Postal Code

The insurance company postal code

IN1.5.5

string

Company - Contact Name

The name of the contact at the insurance company

IN1.6.1

string

Company - Contact Phone

The phone number of the contact at the insurance company

IN1.7.1

string

Group Number

The insurance company group number

IN1.8.1

string

Group Name

The name of the group

IN1.9.1

string

Employer ID

The ID for the employer

IN1.10.1

string

Employer Name

The name of the employer

IN1.11.1

string

Employer Code

The code for the employer

IN1.11.2

string

Plan Effective Date

The date insurance started coverage

IN1.12.1

YYYYMMDD

Plan Expiration Date

The date coverage ends

IN1.13.1

YYYYMMDD

Authorization Number

The authorization number for payment

IN1.14.1

string

Plan Type

The code for the type of insurance plan

IN1.15.1

string

Insured First Name

The first name of the insurance holder

IN1.16.2

string

Insured Middle Name

The middle name of the insurance holder

IN1.16.3

string

Insured Last Name

The last name of the insurance holder

IN1.16.1

string

Insured Relationship to Patient

The relationship between the insurance holder and the patient

IN1.17.1

string

Insured Date of Birth

The date of birth for the insurance holder

IN1.18.1

YYYYMMDD

Insured Address - Street

The street address of the insurance holder

IN1.19.1

string

Insured Address - Line 2

The second line of the address of the insurance holder

IN1.19.2

string

Insured Address - City

The city of the insurance holder

IN1.19.3

string

Insured Address - Province

The state or province of the insurance holder

IN1.19.4

string

Insured Address - Postal Code

The postal code of the insurance holder

IN1.19.5

string

Insured Policy Number

The policy number

IN1.36.1

string

Insured Gender

The gender of the insurance holder

IN1.43.1

string

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