GT1

Guarantor

...

2.6Sep2007

2.7Jan2011

2.7.1Jul2012

...

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		v2.6
1	1..4	-	SI	R	1	-	00405	GT1-1	Set ID - GT1	Min Length
2	-	-	CX	O	*	-	00406	GT1-2	Guarantor Number	Length
3	-	-	XPN	R	*	-	00407	GT1-3	Guarantor Name	Length
4	-	-	XPN	O	*	-	00408	GT1-4	Guarantor Spouse Name	Length
5	-	-	XAD	O	*	-	00409	GT1-5	Guarantor Address	Length
6	-	-	XTN	O	*	-	00410	GT1-6	Guarantor Ph Num - Home	Length
7	-	-	XTN	O	*	-	00411	GT1-7	Guarantor Ph Num - Business	Length
8	-	-	DTM	O	1	-	00412	GT1-8	Guarantor Date/Time Of Birth	Length
9	-	-	CWE	O	1	0001	00413	GT1-9	Guarantor Administrative Sex	2
10	-	-	CWE	O	1	0068	00414	GT1-10	Guarantor Type	2
11	-	-	CWE	O	1	0063	00415	GT1-11	Guarantor Relationship	Length
12	-	11=	ST	O	1	-	00416	GT1-12	Guarantor SSN	2
13	-	-	DT	O	1	-	00417	GT1-13	Guarantor Date - Begin	Length
14	-	-	DT	O	1	-	00418	GT1-14	Guarantor Date - End	Length
15	1..2	-	NM	O	1	-	00419	GT1-15	Guarantor Priority	Min Length
16	-	-	XPN	O	*	-	00420	GT1-16	Guarantor Employer Name	Length
17	-	-	XAD	O	*	-	00421	GT1-17	Guarantor Employer Address	Length
18	-	-	XTN	O	*	-	00422	GT1-18	Guarantor Employer Phone Number	Length
19	-	-	CX	O	*	-	00423	GT1-19	Guarantor Employee ID Number	Length
20	-	-	CWE	O	1	0066	00424	GT1-20	Guarantor Employment Status	2
21	-	-	XON	O	*	-	00425	GT1-21	Guarantor Organization Name	Length
22	1	-	ID	O	1	0136	00773	GT1-22	Guarantor Billing Hold Flag	Min Length
23	-	-	CWE	O	1	0341	00774	GT1-23	Guarantor Credit Rating Code	Length
24	-	-	DTM	O	1	-	00775	GT1-24	Guarantor Death Date And Time	Length
25	1	-	ID	O	1	0136	00776	GT1-25	Guarantor Death Flag	Min Length
26	-	-	CWE	O	1	0218	00777	GT1-26	Guarantor Charge Adjustment Code	Length
27	-	-	CP	O	1	-	00778	GT1-27	Guarantor Household Annual Income	Length
28	-	3=	NM	O	1	-	00779	GT1-28	Guarantor Household Size	2
29	-	-	CX	O	*	-	00780	GT1-29	Guarantor Employer ID Number	Length
30	-	-	CWE	O	1	0002	00781	GT1-30	Guarantor Marital Status Code	Length
31	-	-	DT	O	1	-	00782	GT1-31	Guarantor Hire Effective Date	Length
32	-	-	DT	O	1	-	00783	GT1-32	Employment Stop Date	Length
33	-	-	CWE	O	1	0223	00755	GT1-33	Living Dependency	2
34	-	-	CWE	O	*	0009	00145	GT1-34	Ambulatory Status	2
35	-	-	CWE	O	*	0171	00129	GT1-35	Citizenship	Length
36	-	-	CWE	O	1	0296	00118	GT1-36	Primary Language	Length
37	-	-	CWE	O	1	0220	00742	GT1-37	Living Arrangement	2
38	-	-	CWE	O	1	0215	00743	GT1-38	Publicity Code	Length
39	1	-	ID	O	1	0136	00744	GT1-39	Protection Indicator	2
40	-	-	CWE	O	1	0231	00745	GT1-40	Student Indicator	2
41	-	-	CWE	O	1	0006	00120	GT1-41	Religion	Length
42	-	-	XPN	O	*	-	00109	GT1-42	Mother's Maiden Name	Length
43	-	-	CWE	O	1	0212	00739	GT1-43	Nationality
44	-	-	CWE	O	*	0189	00125	GT1-44	Ethnic Group	Length
45	-	-	XPN	O	*	0200	00748	GT1-45	Contact Person's Name	Length
46	-	-	XTN	O	*	-	00749	GT1-46	Contact Person's Telephone Number	Length
47	-	-	CWE	O	1	0222	00747	GT1-47	Contact Reason	Length
48	-	-	CWE	O	1	0063	00784	GT1-48	Contact Relationship	2
49	-	20#	ST	O	1	-	00785	GT1-49	Job Title	2
50	-	-	JCC	O	1	0327	00786	GT1-50	Job Code/Class	2
51	-	-	XON	O	*	-	01299	GT1-51	Guarantor Employer's Organization Name	Length
52	-	-	CWE	O	1	0295	00753	GT1-52	Handicap	2
53	-	-	CWE	O	1	0311	00752	GT1-53	Job Status	2
54	-	-	FC	O	1	-	01231	GT1-54	Guarantor Financial Class	Length
55	-	-	CWE	O	*	0005	01291	GT1-55	Guarantor Race	Length
56	-	100#	ST	O	1	-	01851	GT1-56	Guarantor Birth Place	2
57	-	-	CWE	O	1	0099	00146	GT1-57	VIP Indicator	2