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
14SIRSet ID – Patient ID
260CERInsurance Plan ID
359CXRYInsurance Company ID
4130XONOYInsurance Company Name
5106XADOYInsurance Company Address
648XPNOYInsurance Co Contact Person
740XTNOYInsurance Co Phone Number
812STOGroup Number
9130XONOYGroup Name
1012CXOYInsured’s Group Emp ID
11130XONOYInsured’s Group Emp Name
128DTOPlan Effective Date
138DTOPlan Expiration Date
1455CMOAuthorization Information
153ISOPlan Type
1648XPNOYName Of Insured
1780CEOInsured’s Relationship To Patient
1826TSOInsured’s Date Of Birth
19160XADOYInsured’s Address
202ISOAssignment Of Benefits
212ISOCoordination Of Benefits
222STOCoord Of Ben. Priority
231IDONotice Of Admission Flag
248DTONotice Of Admission Date
251ISOReport Of Eligibility Flag
268DTOReport Of Eligibility Date
272ISORelease Information Code
2815STOPre-Admit Cert (PAC)
2926TSOVerification Date/Time
3060XCNO YVerification By
312ISOType Of Agreement Code
322ISOBilling Status
334NMOLifetime Reserve Days
344NMODelay Before L.R. Day
358ISOCompany Plan Code
3615STOPolicy Number
3712CPOPolicy Deductible
3812CPOPolicy Limit – Amount
394NMOPolicy Limit – Days
4012CPORoom Rate – Semi-Private
4112CPORoom Rate – Private
4260CERInsured’s Employment Status
431ISRInsured’s Sex
44106XADRYInsured’s Employer’s Address
452STOVerification Status
468ISOPrior Insurance Plan ID
473ISOCoverage Type
482ISOHandicap
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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