GT1
GUARANTOR
The GT1 segment contains Guarantor (e.g., person with financial responsibility for payment of a patient account) data for patient and insurance billing applications.
FIELD NOTES: GT1 GUARANTOR
RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler
20
| C.Len | Element | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| 1 | ..4 | - | SI | R | 1 | - | 00321 | GT1-1 | SET ID - GUARANTOR |
| 2 | ..20 | - | ID | O | 1 | - | 00322 | GT1-2 | GUARANTOR NUMBER |
| 3 | ..48 | - | PN | R | 1 | - | 00323 | GT1-3 | GUARANTOR NAME |
| 4 | ..48 | - | PN | O | 1 | - | 00707 | GT1-4 | GUARANTOR SPOUSE NAME |
| 5 | ..106 | - | AD | O | 1 | - | 00324 | GT1-5 | GUARANTOR ADDRESS |
| 6 | ..40 | - | TN | O | 1 | - | 00329 | GT1-6 | GUARANTOR PH. NUM.- HOME |
| 7 | ..40 | - | TN | O | 1 | - | 00330 | GT1-7 | GUARANTOR PH. NUM-BUSINESS |
| 8 | ..8 | - | DT | O | 1 | - | 00331 | GT1-8 | GUARANTOR DATE OF BIRTH |
| 9 | ..1 | - | ID | O | 1 | 0001 | 00332 | GT1-9 | GUARANTOR SEX |
| 10 | ..2 | - | ID | O | 1 | 0068 | 00333 | GT1-10 | GUARANTOR TYPE |
| 11 | ..2 | - | ID | O | 1 | 0063 | 00334 | GT1-11 | GUARANTOR RELATIONSHIP |
| 12 | ..11 | - | ST | O | 1 | - | 00335 | GT1-12 | GUARANTOR SSN |
| 13 | ..8 | - | DT | O | 1 | - | 00338 | GT1-13 | GUARANTOR DATE - BEGIN |
| 14 | ..8 | - | DT | O | 1 | - | 00339 | GT1-14 | GUARANTOR DATE - END |
| 15 | ..2 | - | NM | O | 1 | - | 00340 | GT1-15 | GUARANTOR PRIORITY |
| 16 | ..45 | - | ST | O | 1 | - | 00341 | GT1-16 | GUARANTOR EMPLOYER NAME |
| 17 | ..106 | - | AD | O | 1 | - | 00342 | GT1-17 | GUARANTOR EMPLOYER ADDRESS |
| 18 | ..40 | - | TN | O | 1 | - | 00347 | GT1-18 | GUARANTOR EMPLOY PHONE# |
| 19 | ..20 | - | ST | O | 1 | - | 00391 | GT1-19 | GUARANTOR EMPLOYEE ID NUM |
| 20 | ..2 | - | ID | O | 1 | 0066 | 00392 | GT1-20 | GUARANTOR EMPLOYMENT STATUS |
Used In Message Structures