IN2

Insurance Additional Information

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 CMS or other regulatory agencies.
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C.LenElementv2.8.1
1--CXO*-00472IN2-1Insured's Employee ID
2-11=STO1-00473IN2-2Insured's Social Security NumberConf Length
3--XCNO*-00474IN2-3Insured's Employer's Name and ID
4--CWEO1013900475IN2-4Employer Information Data
5--CWEO*013700476IN2-5Mail Claim Party
6-15=STO1-00477IN2-6Medicare Health Ins Card NumberConf Length
7--XPNO*-00478IN2-7Medicaid Case Name
8-15=STO1-00479IN2-8Medicaid Case NumberConf Length
9--XPNO*-00480IN2-9Military Sponsor Name
10-20=STO1-00481IN2-10Military ID NumberConf Length
11--CWEO1034200482IN2-11Dependent Of Military Recipient
12-25=STO1-00483IN2-12Military OrganizationConf Length
13-25=STO1-00484IN2-13Military StationConf Length
14--CWEO1014000485IN2-14Military Service
15--CWEO1014100486IN2-15Military Rank/Grade
16--CWEO1014200487IN2-16Military Status
17--DTO1-00488IN2-17Military Retire Date
181-IDO1013600489IN2-18Military Non-Avail Cert On File
191-IDO1013600490IN2-19Baby Coverage
201-IDO1013600491IN2-20Combine Baby Bill
21-1=STO1-00492IN2-21Blood DeductibleConf Length
22--XPNO*-00493IN2-22Special Coverage Approval Name
23-30#STO1-00494IN2-23Special Coverage Approval TitleConf Length
24--CWEO*014300495IN2-24Non-Covered Insurance Code
25--CXO*-00496IN2-25Payor ID
26--CXO*-00497IN2-26Payor Subscriber ID
27--CWEO1014400498IN2-27Eligibility Source
28--RMCO*-00499IN2-28Room Coverage Type/Amount
29--PTAO*-00500IN2-29Policy Type/Amount
30--DDIO1-00501IN2-30Daily Deductible
31--CWEO1022300755IN2-31Living Dependency
32--CWEO*000900145IN2-32Ambulatory Status
33--CWEO*017100129IN2-33Citizenship
34--CWEO1029600118IN2-34Primary Language
35--CWEO1022000742IN2-35Living Arrangement
36--CWEO1021500743IN2-36Publicity Code
371-IDO1013600744IN2-37Protection Indicator
38--CWEO1023100745IN2-38Student Indicator
39--CWEO1000600120IN2-39Religion
40--XPNO*-00109IN2-40Mother's Maiden Name
41--CWEO1021200739IN2-41Nationality
42--CWEO*018900125IN2-42Ethnic Group
43--CWEO*000200119IN2-43Marital Status
44--DTO1-00787IN2-44Insured's Employment Start Date
45--DTO1-00783IN2-45Employment Stop Date
46-20#STO1-00785IN2-46Job TitleConf Length
47--JCCO1-00786IN2-47Job Code/Class
48--CWEO1031100752IN2-48Job Status
49--XPNO*-00789IN2-49Employer Contact Person Name
50--XTNO*-00790IN2-50Employer Contact Person Phone Number
51--CWEO1022200791IN2-51Employer Contact Reason
52--XPNO*-00792IN2-52Insured's Contact Person's Name
53--XTNO*-00793IN2-53Insured's Contact Person Phone Number
54--CWEO*022200794IN2-54Insured's Contact Person Reason
55--DTO1-00795IN2-55Relationship to the Patient Start Date
56--DTO*-00796IN2-56Relationship to the Patient Stop Date
57--CWEO1023200797IN2-57Insurance Co Contact Reason
58--XTNO*-00798IN2-58Insurance Co Contact Phone Number
59--CWEO1031200799IN2-59Policy Scope
60--CWEO1031300800IN2-60Policy Source
61--CXO1-00801IN2-61Patient Member Number
62--CWEO1006300802IN2-62Guarantor's Relationship to Insured
63--XTNO*-00803IN2-63Insured's Phone Number - Home
64--XTNO*-00804IN2-64Insured's Employer Phone Number
65--CWEO1034300805IN2-65Military Handicapped Program
661-IDO1013600806IN2-66Suspend Flag
671-IDO1013600807IN2-67Copay Limit Flag
681-IDO1013600808IN2-68Stoploss Limit Flag
69--XONO*-00809IN2-69Insured Organization Name and ID
70--XONO*-00810IN2-70Insured Employer Organization Name and ID
71--CWEO*000500113IN2-71Race
72--CWEO1034400811IN2-72Patient's Relationship to Insured
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