HL7® Definition

 

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IN3: Insurance Additional Info-certification

SEQLENGTHDTOPTRPT / #TBL #NAME
IN3.14SIR1Set Id - Insurance Certification
IN3.225STO1Certification Number
IN3.360CN_PERSONO1Certified By
IN3.41IDO10136Certification Required
IN3.510CM_PENO10148Penalty
IN3.626TSO1Certification Date / Time
IN3.726TSO1Certification Modify Date / Time
IN3.860CN_PERSONO1Operator
IN3.98DTO1Certification Begin Date
IN3.108DTO1Certification End Date
IN3.113CM_DTNO10149Days
IN3.1260CEO1Non-concur Code / Description
IN3.1326TSO1Non-concur Effective Date / Time
IN3.1460CN_PERSONO1Physician Reviewer
IN3.1548STO1Certification Contact
IN3.1640TNO3Certification Contact Phone Number
IN3.1760CEO1Appeal Reason
IN3.1860CEO1Certification Agency
IN3.1940TNO3Certification Agency Phone Number
IN3.2040CM_PCFO*0150Pre-certification Required / Window
IN3.2148STO1Case Manager
IN3.228DTO1Second Opinion Date
IN3.231IDO10151Second Opinion Status
IN3.241IDO10152Second Opinion Documentation Received
IN3.2560CN_PERSONO1Second Opinion Practitioner

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