GT1

Guarantor

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.
57
C.LenElementv2.8.1
11..4-SIR1-00405GT1-1Set ID - GT1
2--CXO*-00406GT1-2Guarantor Number
3--XPNR*-00407GT1-3Guarantor Name
4--XPNO*-00408GT1-4Guarantor Spouse Name
5--XADO*-00409GT1-5Guarantor Address
6--XTNO*-00410GT1-6Guarantor Ph Num - Home
7--XTNO*-00411GT1-7Guarantor Ph Num - Business
8--DTMO1-00412GT1-8Guarantor Date/Time Of Birth
9--CWEO1000100413GT1-9Guarantor Administrative Sex
10--CWEO1006800414GT1-10Guarantor Type
11--CWEO1006300415GT1-11Guarantor Relationship
12-11=STO1-00416GT1-12Guarantor SSNConf Length
13--DTO1-00417GT1-13Guarantor Date - Begin
14--DTO1-00418GT1-14Guarantor Date - End
151..2-NMO1-00419GT1-15Guarantor Priority
16--XPNO*-00420GT1-16Guarantor Employer Name
17--XADO*-00421GT1-17Guarantor Employer Address
18--XTNO*-00422GT1-18Guarantor Employer Phone Number
19--CXO*-00423GT1-19Guarantor Employee ID Number
20--CWEO1006600424GT1-20Guarantor Employment Status
21--XONO*-00425GT1-21Guarantor Organization Name
221-IDO1013600773GT1-22Guarantor Billing Hold Flag
23--CWEO1034100774GT1-23Guarantor Credit Rating Code
24--DTMO1-00775GT1-24Guarantor Death Date And Time
251-IDO1013600776GT1-25Guarantor Death Flag
26--CWEO1021800777GT1-26Guarantor Charge Adjustment Code
27--CPO1-00778GT1-27Guarantor Household Annual Income
28-3=NMO1-00779GT1-28Guarantor Household SizeConf Length
29--CXO*-00780GT1-29Guarantor Employer ID Number
30--CWEO1000200781GT1-30Guarantor Marital Status Code
31--DTO1-00782GT1-31Guarantor Hire Effective Date
32--DTO1-00783GT1-32Employment Stop Date
33--CWEO1022300755GT1-33Living Dependency
34--CWEO*000900145GT1-34Ambulatory Status
35--CWEO*017100129GT1-35Citizenship
36--CWEO1029600118GT1-36Primary Language
37--CWEO1022000742GT1-37Living Arrangement
38--CWEO1021500743GT1-38Publicity Code
391-IDO1013600744GT1-39Protection Indicator
40--CWEO1023100745GT1-40Student Indicator
41--CWEO1000600120GT1-41Religion
42--XPNO*-00109GT1-42Mother's Maiden Name
43--CWEO1021200739GT1-43Nationality
44--CWEO*018900125GT1-44Ethnic Group
45--XPNO*-00748GT1-45Contact Person's Name
46--XTNO*-00749GT1-46Contact Person's Telephone Number
47--CWEO1022200747GT1-47Contact Reason
48--CWEO1006300784GT1-48Contact Relationship
49-20#STO1-00785GT1-49Job TitleConf Length
50--JCCO1-00786GT1-50Job Code/Class
51--XONO*-01299GT1-51Guarantor Employer's Organization Name
52--CWEO1029500753GT1-52Handicap
53--CWEO1031100752GT1-53Job Status
54--FCO1-01231GT1-54Guarantor Financial Class
55--CWEO*000501291GT1-55Guarantor Race
56-100#STO1-01851GT1-56Guarantor Birth PlaceConf Length
57--CWEO1009900146GT1-57VIP Indicator
31