function isSegmentEmpty(segs)
{
var data=""+segs;
data=data.replace(/\|/g,""); // replace pipeline
data=data.replace(/\"/g,""); // replace quotation
data=data.trim();
//WriteErrLog("Insurance Data isSegmentEmpty function: "+data);
return data;
}
03 March, 2015
11 December, 2014
IN3 - HL7 Segment Reference
IN3 - Insurance Additional Information, Certification Segment.
The IN3 segment contains additional insurance
information for certifying the need for patient care. Fields used by this segment are defined by
HCFA, or other regulatory agencies. HL7 Attribute Table - IN3 –
Insurance Additional Information, Certification.
SEQ
|
LEN
|
DT
|
ITEM#
|
ELEMENT
NAME
|
1
|
4
|
SI
|
00502
|
Set ID - IN3
|
2
|
250
|
CX
|
00503
|
Certification
Number
|
3
|
250
|
XCN
|
00504
|
Certified By
|
4
|
1
|
ID
|
00505
|
Certification
Required
|
5
|
10
|
CM
|
00506
|
Penalty
|
6
|
26
|
TS
|
00507
|
Certification
Date/Time
|
7
|
26
|
TS
|
00508
|
Certification
Modify Date/Time
|
8
|
250
|
XCN
|
00509
|
Operator
|
9
|
8
|
DT
|
00510
|
Certification
Begin Date
|
10
|
8
|
DT
|
00511
|
Certification
End Date
|
11
|
3
|
CM
|
00512
|
Days
|
12
|
250
|
CE
|
00513
|
Non-Concur
Code/Description
|
13
|
26
|
TS
|
00514
|
Non-Concur
Effective Date/Time
|
14
|
250
|
XCN
|
00515
|
Physician
Reviewer
|
15
|
48
|
ST
|
00516
|
Certification
Contact
|
16
|
250
|
XTN
|
00517
|
Certification
Contact Phone Number
|
17
|
250
|
CE
|
00518
|
Appeal Reason
|
18
|
250
|
CE
|
00519
|
Certification
Agency
|
19
|
250
|
XTN
|
00520
|
Certification
Agency Phone Number
|
20
|
40
|
CM
|
00521
|
Pre-Certification
Req/Window
|
21
|
48
|
ST
|
00522
|
Case Manager
|
22
|
8
|
DT
|
00523
|
Second Opinion
Date
|
23
|
1
|
IS
|
00524
|
Second Opinion
Status
|
24
|
1
|
IS
|
00525
|
Second Opinion
Documentation Received
|
25
|
250
|
XCN
|
00526
|
Second Opinion
Physician
|
IN2 - HL7 Segment Reference
IN2 - Insurance Additional Information Segment.
The IN2 segment contains additional insurance policy
coverage and benefit information necessary for proper billing and
reimbursement. Fields used by this
segment are defined by HCFA or other regulatory agencies.HL7 Attribute Table - IN2 –
Insurance Additional Information.
SEQ
|
LEN
|
DT
|
ITEM#
|
ELEMENT
NAME
|
1
|
250
|
CX
|
00472
|
Insured’s
Employee ID
|
2
|
11
|
ST
|
00473
|
Insured’s
Social Security Number
|
3
|
250
|
XCN
|
00474
|
Insured’s
Employer’s Name and ID
|
4
|
1
|
IS
|
00475
|
Employer
Information Data
|
5
|
1
|
IS
|
00476
|
Mail Claim
Party
|
6
|
15
|
ST
|
00477
|
Medicare
Health Ins Card Number
|
7
|
250
|
XPN
|
00478
|
Medicaid Case
Name
|
8
|
15
|
ST
|
00479
|
Medicaid Case
Number
|
9
|
250
|
XPN
|
00480
|
Military Sponsor
Name
|
10
|
20
|
ST
|
00481
|
Military ID
Number
|
11
|
250
|
CE
|
00482
|
Dependent Of
Military Recipient
|
12
|
25
|
ST
|
00483
|
Military
Organization
|
13
|
25
|
ST
|
00484
|
Military
Station
|
14
|
14
|
IS
|
00485
|
Military
Service
|
15
|
2
|
IS
|
00486
|
Military
Rank/Grade
|
16
|
3
|
IS
|
00487
|
Military
Status
|
17
|
8
|
DT
|
00488
|
Military
Retire Date
|
18
|
1
|
ID
|
00489
|
Military
Non-Avail Cert On File
|
19
|
1
|
ID
|
00490
|
Baby Coverage
|
20
|
1
|
ID
|
00491
|
Combine Baby
Bill
|
21
|
1
|
ST
|
00492
|
Blood
Deductible
|
22
|
250
|
XPN
|
00493
|
Special
Coverage Approval Name
|
23
|
30
|
ST
|
00494
|
Special
Coverage Approval Title
|
24
|
8
|
IS
|
00495
|
Non-Covered
Insurance Code
|
25
|
250
|
CX
|
00496
|
Payor ID
|
26
|
250
|
CX
|
00497
|
Payor
Subscriber ID
|
27
|
1
|
IS
|
00498
|
Eligibility
Source
|
28
|
250
|
CM
|
00499
|
Room Coverage
Type/Amount
|
29
|
250
|
CM
|
00500
|
Policy
Type/Amount
|
30
|
250
|
CM
|
00501
|
Daily
Deductible
|
31
|
2
|
IS
|
00755
|
Living
Dependency
|
32
|
2
|
IS
|
00145
|
Ambulatory
Status
|
33
|
250
|
CE
|
00129
|
Citizenship
|
34
|
250
|
CE
|
00118
|
Primary
Language
|
35
|
2
|
IS
|
00742
|
Living
Arrangement
|
36
|
250
|
CE
|
00743
|
Publicity Code
|
37
|
1
|
ID
|
00744
|
Protection
Indicator
|
38
|
2
|
IS
|
00745
|
Student
Indicator
|
39
|
250
|
CE
|
00120
|
Religion
|
40
|
250
|
XPN
|
00109
|
Mother’s
Maiden Name
|
41
|
250
|
CE
|
00739
|
Nationality
|
42
|
250
|
CE
|
00125
|
Ethnic Group
|
43
|
250
|
CE
|
00119
|
Marital Status
|
44
|
8
|
DT
|
00787
|
Insured’s
Employment Start Date
|
45
|
8
|
DT
|
00783
|
Employment
Stop Date
|
46
|
20
|
ST
|
00785
|
Job Title
|
47
|
20
|
JCC
|
00786
|
Job Code/Class
|
48
|
2
|
IS
|
00752
|
Job Status
|
49
|
250
|
XPN
|
00789
|
Employer
Contact Person Name
|
50
|
250
|
XTN
|
00790
|
Employer
Contact Person Phone Number
|
51
|
2
|
IS
|
00791
|
Employer
Contact Reason
|
52
|
250
|
XPN
|
00792
|
Insured’s
Contact Person’s Name
|
53
|
250
|
XTN
|
00793
|
Insured’s
Contact Person Phone Number
|
54
|
2
|
IS
|
00794
|
Insured’s
Contact Person Reason
|
55
|
8
|
DT
|
00795
|
Relationship
To The Patient Start Date
|
56
|
8
|
DT
|
00796
|
Relationship
To The Patient Stop Date
|
57
|
2
|
IS
|
00797
|
Insurance Co.
Contact Reason
|
58
|
250
|
XTN
|
00798
|
Insurance Co
Contact Phone Number
|
59
|
2
|
IS
|
00799
|
Policy Scope
|
60
|
2
|
IS
|
00800
|
Policy Source
|
61
|
250
|
CX
|
00801
|
Patient Member
Number
|
62
|
250
|
CE
|
00802
|
Guarantor’s
Relationship To Insured
|
63
|
250
|
XTN
|
00803
|
Insured’s Phone
Number - Home
|
64
|
250
|
XTN
|
00804
|
Insured’s
Employer Phone Number
|
65
|
250
|
CE
|
00805
|
Military
Handicapped Program
|
66
|
1
|
ID
|
00806
|
Suspend Flag
|
67
|
1
|
ID
|
00807
|
Copay Limit
Flag
|
68
|
1
|
ID
|
00808
|
Stoploss Limit
Flag
|
69
|
250
|
XON
|
00809
|
Insured
Organization Name And ID
|
70
|
250
|
XON
|
00810
|
Insured
Employer Organization Name And ID
|
71
|
250
|
CE
|
00113
|
Race
|
72
|
250
|
CE
|
00811
|
HCFA Patient’s
Relationship to Insured
|
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