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active Template  IN3 - Insurance Additional Information, Certification

Id 2.16.840.1.113883.3.1937.777.10.13.58
ref
ad4bbr-
 		Ingangsdatum 2013‑02‑10
Status active Actief Versielabel
Naam IN3_segment Weergavenaam IN3 - Insurance Additional Information, Certification
Classificatie HL7v2 segment level template
Open/gesloten Open (ook andere dan gedefinieerde elementen zijn toegestaan)
Gebruikt door / Gebruikt
Gebruikt door 0 transacties en 1 template, Gebruikt 13 templates
Gebruikt door als Naam Versie
2.16.840.1.113883.2.4.3.11.60.25.10.1 Containment draft Lab2Lab Aanvraagbericht (OML^O21) 2015‑07‑21 11:35:02
Gebruikt als Naam Versie
2.16.840.1.113883.3.1937.777.10.15.88 Containment active SI - Sequence ID DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.12 Containment active CX - Extended composite ID with check digit DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.74 Containment active XCN - Extended composite ID number and name for persons DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.83 Containment active ID - Coded value for HL7 defined tables DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.35 Containment active MOP - Money or percentage DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.64 Containment active TS - Time stamp DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.80 Containment active DT - Date DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.19 Containment active DTN - Day type and number DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.5 Containment active CE - Coded element DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.89 Containment active ST - String DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.77 Containment active XTN - Extended telecommunications number DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.29 Containment active ICD - Insurance certification definition DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.84 Containment active IS - Coded value for user-defined tables DYNAMISCH
Item DT Card Conf Omschrijving Label
hl7v2:IN3.1
 SI 1 … 1 en-US Set ID - IN3
Bevat 2.16.840.1.113883.3.1937.777.10.15.88 SI - Sequence ID (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 502
@Type
 0 … 1 F SI
@LongName
 0 … 1 F Set ID - IN3
hl7v2:IN3.2
 CX 0 … 1 en-US Certification Number
Bevat 2.16.840.1.113883.3.1937.777.10.15.12 CX - Extended composite ID with check digit (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 503
@Type
 0 … 1 F CX
@LongName
 0 … 1 F Certification Number
hl7v2:IN3.3
 XCN 0 … * en-US Certified By
Bevat 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 504
@Type
 0 … 1 F XCN
@LongName
 0 … 1 F Certified By
hl7v2:IN3.4
 ID 0 … 1 en-US Certification Required
Bevat 2.16.840.1.113883.3.1937.777.10.15.83 ID - Coded value for HL7 defined tables (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 505
@Type
 0 … 1 F ID
@Table
 0 … 1 F HL70136
@LongName
 0 … 1 F Certification Required
hl7v2:IN3.5
 MOP 0 … 1 en-US Penalty
Bevat 2.16.840.1.113883.3.1937.777.10.15.35 MOP - Money or percentage (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 506
@Type
 0 … 1 F MOP
@LongName
 0 … 1 F Penalty
hl7v2:IN3.6
 TS 0 … 1 en-US Certification Date/Time
Bevat 2.16.840.1.113883.3.1937.777.10.15.64 TS - Time stamp (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 507
@Type
 0 … 1 F TS
@LongName
 0 … 1 F Certification Date/Time
hl7v2:IN3.7
 TS 0 … 1 en-US Certification Modify Date/Time
Bevat 2.16.840.1.113883.3.1937.777.10.15.64 TS - Time stamp (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 508
@Type
 0 … 1 F TS
@LongName
 0 … 1 F Certification Modify Date/Time
hl7v2:IN3.8
 XCN 0 … * en-US Operator
Bevat 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 509
@Type
 0 … 1 F XCN
@LongName
 0 … 1 F Operator
hl7v2:IN3.9
 DT 0 … 1 en-US Certification Begin Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 510
@Type
 0 … 1 F DT
@LongName
 0 … 1 F Certification Begin Date
hl7v2:IN3.10
 DT 0 … 1 en-US Certification End Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 511
@Type
 0 … 1 F DT
@LongName
 0 … 1 F Certification End Date
hl7v2:IN3.11
 DTN 0 … 1 en-US Days
Bevat 2.16.840.1.113883.3.1937.777.10.15.19 DTN - Day type and number (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 512
@Type
 0 … 1 F DTN
@LongName
 0 … 1 F Days
hl7v2:IN3.12
 CE 0 … 1 en-US Non-Concur Code/Description
Bevat 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 513
@Type
 0 … 1 F CE
@Table
 0 … 1 F HL70233
@LongName
 0 … 1 F Non-Concur Code/Description
hl7v2:IN3.13
 TS 0 … 1 en-US Non-Concur Effective Date/Time
Bevat 2.16.840.1.113883.3.1937.777.10.15.64 TS - Time stamp (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 514
@Type
 0 … 1 F TS
@LongName
 0 … 1 F Non-Concur Effective Date/Time
hl7v2:IN3.14
 XCN 0 … * en-US Physician Reviewer
Bevat 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 515
@Type
 0 … 1 F XCN
@Table
 0 … 1 F HL70010
@LongName
 0 … 1 F Physician Reviewer
hl7v2:IN3.15
 ST 0 … 1 en-US Certification Contact
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 516
@Type
 0 … 1 F ST
@LongName
 0 … 1 F Certification Contact
hl7v2:IN3.16
 XTN 0 … * en-US Certification Contact Phone Number
Bevat 2.16.840.1.113883.3.1937.777.10.15.77 XTN - Extended telecommunications number (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 517
@Type
 0 … 1 F XTN
@LongName
 0 … 1 F Certification Contact Phone Number
hl7v2:IN3.17
 CE 0 … 1 en-US Appeal Reason
Bevat 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 518
@Type
 0 … 1 F CE
@Table
 0 … 1 F HL70345
@LongName
 0 … 1 F Appeal Reason
hl7v2:IN3.18
 CE 0 … 1 en-US Certification Agency
Bevat 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 519
@Type
 0 … 1 F CE
@Table
 0 … 1 F HL70346
@LongName
 0 … 1 F Certification Agency
hl7v2:IN3.19
 XTN 0 … * en-US Certification Agency Phone Number
Bevat 2.16.840.1.113883.3.1937.777.10.15.77 XTN - Extended telecommunications number (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 520
@Type
 0 … 1 F XTN
@LongName
 0 … 1 F Certification Agency Phone Number
hl7v2:IN3.20
 ICD 0 … * en-US Pre-Certification Requirement
Bevat 2.16.840.1.113883.3.1937.777.10.15.29 ICD - Insurance certification definition (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 521
@Type
 0 … 1 F ICD
@LongName
 0 … 1 F Pre-Certification Requirement
hl7v2:IN3.21
 ST 0 … 1 en-US Case Manager
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 522
@Type
 0 … 1 F ST
@LongName
 0 … 1 F Case Manager
hl7v2:IN3.22
 DT 0 … 1 en-US Second Opinion Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 523
@Type
 0 … 1 F DT
@LongName
 0 … 1 F Second Opinion Date
hl7v2:IN3.23
 IS 0 … 1 en-US Second Opinion Status
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 524
@Type
 0 … 1 F IS
@Table
 0 … 1 F HL70151
@LongName
 0 … 1 F Second Opinion Status
hl7v2:IN3.24
 IS 0 … * en-US Second Opinion Documentation Received
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 525
@Type
 0 … 1 F IS
@Table
 0 … 1 F HL70152
@LongName
 0 … 1 F Second Opinion Documentation Received
hl7v2:IN3.25
 XCN 0 … * en-US Second Opinion Physician
Bevat 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMISCH) 		(IN3dotsent)
@Item
 0 … 1 F 526
@Type
 0 … 1 F XCN
@Table
 0 … 1 F HL70010
@LongName
 0 … 1 F Second Opinion Physician