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 – 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 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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