HL7® Definition

 

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IN3: Insurance additional information, certification segment

The IN3 segment contains additional insurance information for certifying the need for patient care. Fields used by this segment are defined by HCFA, or other regulatory agencies.

SEQLENGTHDTOPTRPT / #TBL #NAME
IN3.14SIR1Set ID - IN3
IN3.259CXO1Certification Number
IN3.360XCNO*Certified By
IN3.41IDO10136Certification Required
IN3.510MOPO1Penalty
IN3.626TSO1Certification Date/Time
IN3.726TSO1Certification Modify Date/Time
IN3.860XCNO*Operator
IN3.98DTO1Certification Begin Date
IN3.108DTO1Certification End Date
IN3.113DTNO1Days
IN3.1260CEO1Non-Concur Code/Description
IN3.1326TSO1Non-Concur Effective Date/Time
IN3.1460XCNO*Physician Reviewer
IN3.1548STO1Certification Contact
IN3.1640XTNO*Certification Contact Phone Number
IN3.1760CEO1Appeal Reason
IN3.1860CEO1Certification Agency
IN3.1940XTNO*Certification Agency Phone Number
IN3.2040PCFO*Pre-Certification Req/Window
IN3.2148STO1Case Manager
IN3.228DTO1Second Opinion Date
IN3.231ISO10151Second Opinion Status
IN3.241ISO*0152Second Opinion Documentation Received
IN3.2560XCNO*Second Opinion Physician

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