HL7 resources

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:

SEQLENDTOPTRP/#ELEMENT NAME
14SIR Set ID – Patient ID
260CER Insurance Plan ID
359CXRYInsurance Company ID
4130XONOYInsurance Company Name
5106XADOYInsurance Company Address
648XPNOYInsurance Co Contact Person
740XTNOYInsurance Co Phone Number
812STO Group Number
9130XONOYGroup Name
1012CXOYInsured’s Group Emp ID
11130XONOYInsured’s Group Emp Name
128DTO Plan Effective Date
138DTO Plan Expiration Date
1455CMO Authorization Information
153ISO Plan Type
1648XPNOYName Of Insured
1780CEO Insured’s Relationship To Patient
1826TSO Insured’s Date Of Birth
19160XADOYInsured’s Address
202ISO Assignment Of Benefits
212ISO Coordination Of Benefits
222STO Coord Of Ben. Priority
231IDO Notice Of Admission Flag
248DTO Notice Of Admission Date
251ISO Report Of Eligibility Flag
268DTO Report Of Eligibility Date
272ISO Release Information Code
2815STO Pre-Admit Cert (PAC)
2926TSO Verification Date/Time
3060XCNO YVerification By
312ISO Type Of Agreement Code
322ISO Billing Status
334NMO Lifetime Reserve Days
344NMO Delay Before L.R. Day
358ISO Company Plan Code
3615STO Policy Number
3712CPO Policy Deductible
3812CPO Policy Limit – Amount
394NMO Policy Limit – Days
4012CPO Room Rate – Semi-Private
4112CPO Room Rate – Private
4260CER Insured’s Employment Status
431ISR Insured’s Sex
44106XADRYInsured’s Employer’s Address
452STO Verification Status
468ISO Prior Insurance Plan ID
473ISO Coverage Type
482ISO Handicap
4912CXO YInsured’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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