IN2
INSURANCE ADDITIONAL INFO
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 HICFA or other regulatory agencies.
Figure 6-6 IN2 attributes
RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler
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| C.Len | Element | v2.1 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ..15 | - | ST | O | 1 | - | 00472 | IN2-1 | Insured's employee ID | NEW |
| 2 | ..9 | - | ST | O | 1 | - | 00473 | IN2-2 | Insured's social security number | NEW |
| 3 | ..60 | - | CN_PERSON | O | 1 | - | 00474 | IN2-3 | Insured's employer name | NEW |
| 4 | ..1 | - | ID | O | 1 | 0139 | 00475 | IN2-4 | Employer information data | NEW |
| 5 | ..1 | - | ID | O | 1 | 0137 | 00476 | IN2-5 | Mail claim party | NEW |
| 6 | ..15 | - | NM | O | 1 | - | 00477 | IN2-6 | Medicare health insurance card number | NEW |
| 7 | ..48 | - | PN | O | 1 | - | 00478 | IN2-7 | Medicaid case name | NEW |
| 8 | ..15 | - | NM | O | 1 | - | 00479 | IN2-8 | Medicaid case number | NEW |
| 9 | ..48 | - | PN | O | 1 | - | 00480 | IN2-9 | Champus sponsor name | NEW |
| 10 | ..20 | - | NM | O | 1 | - | 00481 | IN2-10 | Champus ID number | NEW |
| 11 | ..1 | - | ID | O | 1 | - | 00482 | IN2-11 | Dependent of champus recipient | NEW |
| 12 | ..25 | - | ST | O | 1 | - | 00483 | IN2-12 | Champus organization | NEW |
| 13 | ..25 | - | ST | O | 1 | - | 00484 | IN2-13 | Champus station | NEW |
| 14 | ..14 | - | ID | O | 1 | 0140 | 00485 | IN2-14 | Champus service | NEW |
| 15 | ..2 | - | ID | O | 1 | 0141 | 00486 | IN2-15 | Champus rank / grade | NEW |
| 16 | ..3 | - | ID | O | 1 | 0142 | 00487 | IN2-16 | Champus status | NEW |
| 17 | ..8 | - | DT | O | 1 | - | 00488 | IN2-17 | Champus retire date | NEW |
| 18 | ..1 | - | ID | O | 1 | 0136 | 00489 | IN2-18 | Champus non-availability certification on file | NEW |
| 19 | ..1 | - | ID | O | 1 | 0136 | 00490 | IN2-19 | Baby coverage | NEW |
| 20 | ..1 | - | ID | O | 1 | 0136 | 00491 | IN2-20 | Combine baby bill | NEW |
| 21 | ..1 | - | NM | O | 1 | - | 00531 | IN2-21 | Blood deductible | NEW |
| 22 | ..48 | - | PN | O | 1 | - | 00493 | IN2-22 | Special coverage approval name | NEW |
| 23 | ..30 | - | ST | O | 1 | - | 00494 | IN2-23 | Special coverage approval title | NEW |
| 24 | ..8 | - | ID | O | * | 0143 | 00495 | IN2-24 | Non-covered insurance code | NEW |
| 25 | ..6 | - | ST | O | 1 | - | 00496 | IN2-25 | Payor ID | NEW |
| 26 | ..6 | - | ST | O | 1 | - | 00497 | IN2-26 | Payor subscriber ID | NEW |
| 27 | ..1 | - | ID | O | 1 | 0144 | 00498 | IN2-27 | Eligibility source | NEW |
| 28 | ..25 | - | CM_RMC | O | * | 0145 | 00499 | IN2-28 | Room coverage type / amount | NEW |
| 29 | ..25 | - | CM_PTA | O | * | 0147 | 00500 | IN2-29 | Policy type / amount | NEW |
| 30 | ..25 | - | CM_DDI | O | 1 | - | 00501 | IN2-30 | Daily deductible | NEW |
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