GT1

Guarantor

...

2.5Aug2003

2.5.1May2007

2.6Sep2007

...

The GT1 segment contains guarantor (e.g., the person or the organization with financial responsibility for payment of a patient account) data for patient and insurance billing applications.

RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler

		C.Len						Element
1	..4	-	SI	R	1	-	00405	GT1-1	Set ID - GT1
2	..250	-	CX	O	*	-	00406	GT1-2	Guarantor Number
3	..250	-	XPN	R	*	-	00407	GT1-3	Guarantor Name
4	..250	-	XPN	O	*	-	00408	GT1-4	Guarantor Spouse Name
5	..250	-	XAD	O	*	-	00409	GT1-5	Guarantor Address
6	..250	-	XTN	O	*	-	00410	GT1-6	Guarantor Ph Num - Home
7	..250	-	XTN	O	*	-	00411	GT1-7	Guarantor Ph Num - Business
8	..26	-	TS	O	1	-	00412	GT1-8	Guarantor Date/Time Of Birth
9	..1	-	IS	O	1	0001	00413	GT1-9	Guarantor Administrative Sex
10	..2	-	IS	O	1	0068	00414	GT1-10	Guarantor Type
11	..250	-	CE	O	1	0063	00415	GT1-11	Guarantor Relationship
12	..11	-	ST	O	1	-	00416	GT1-12	Guarantor SSN
13	..8	-	DT	O	1	-	00417	GT1-13	Guarantor Date - Begin
14	..8	-	DT	O	1	-	00418	GT1-14	Guarantor Date - End
15	..2	-	NM	O	1	-	00419	GT1-15	Guarantor Priority
16	..250	-	XPN	O	*	-	00420	GT1-16	Guarantor Employer Name
17	..250	-	XAD	O	*	-	00421	GT1-17	Guarantor Employer Address
18	..250	-	XTN	O	*	-	00422	GT1-18	Guarantor Employer Phone Number
19	..250	-	CX	O	*	-	00423	GT1-19	Guarantor Employee ID Number
20	..2	-	IS	O	1	0066	00424	GT1-20	Guarantor Employment Status
21	..250	-	XON	O	*	-	00425	GT1-21	Guarantor Organization Name
22	..1	-	ID	O	1	0136	00773	GT1-22	Guarantor Billing Hold Flag
23	..250	-	CE	O	1	0341	00774	GT1-23	Guarantor Credit Rating Code
24	..26	-	TS	O	1	-	00775	GT1-24	Guarantor Death Date And Time
25	..1	-	ID	O	1	0136	00776	GT1-25	Guarantor Death Flag
26	..250	-	CE	O	1	0218	00777	GT1-26	Guarantor Charge Adjustment Code
27	..10	-	CP	O	1	-	00778	GT1-27	Guarantor Household Annual Income
28	..3	-	NM	O	1	-	00779	GT1-28	Guarantor Household Size
29	..250	-	CX	O	*	-	00780	GT1-29	Guarantor Employer ID Number
30	..250	-	CE	O	1	0002	00781	GT1-30	Guarantor Marital Status Code
31	..8	-	DT	O	1	-	00782	GT1-31	Guarantor Hire Effective Date
32	..8	-	DT	O	1	-	00783	GT1-32	Employment Stop Date
33	..2	-	IS	O	1	0223	00755	GT1-33	Living Dependency
34	..2	-	IS	O	*	0009	00145	GT1-34	Ambulatory Status
35	..250	-	CE	O	*	0171	00129	GT1-35	Citizenship
36	..250	-	CE	O	1	0296	00118	GT1-36	Primary Language
37	..2	-	IS	O	1	0220	00742	GT1-37	Living Arrangement
38	..250	-	CE	O	1	0215	00743	GT1-38	Publicity Code
39	..1	-	ID	O	1	0136	00744	GT1-39	Protection Indicator
40	..2	-	IS	O	1	0231	00745	GT1-40	Student Indicator
41	..250	-	CE	O	1	0006	00120	GT1-41	Religion
42	..250	-	XPN	O	*	-	00109	GT1-42	Mother's Maiden Name
43	..250	-	CE	O	1	0212	00739	GT1-43	Nationality
44	..250	-	CE	O	*	0189	00125	GT1-44	Ethnic Group
45	..250	-	XPN	O	*	-	00748	GT1-45	Contact Person's Name
46	..250	-	XTN	O	*	-	00749	GT1-46	Contact Person's Telephone Number
47	..250	-	CE	O	1	0222	00747	GT1-47	Contact Reason
48	..3	-	IS	O	1	0063	00784	GT1-48	Contact Relationship
49	..20	-	ST	O	1	-	00785	GT1-49	Job Title
50	..20	-	JCC	O	1	-	00786	GT1-50	Job Code/Class
51	..250	-	XON	O	*	-	01299	GT1-51	Guarantor Employer's Organization Name
52	..2	-	IS	O	1	0295	00753	GT1-52	Handicap
53	..2	-	IS	O	1	0311	00752	GT1-53	Job Status
54	..50	-	FC	O	1	-	01231	GT1-54	Guarantor Financial Class
55	..250	-	CE	O	*	0005	01291	GT1-55	Guarantor Race
56	..250	-	ST	O	1	-	01851	GT1-56	Guarantor Birth Place
57	..2	-	IS	O	1	0099	00146	GT1-57	VIP Indicator