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HL7 patient insurance question

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  • HL7 patient insurance question

    I am using Mirth for various HL7 interfaces. I am currently implementing a new one and an interesting issue appeared.
    How are people communicating self pay patients?

    Is there a proper way to do this in HL7?
    The IN1 segment doesn't seem appropriate as so many required fields don't fit. In speaking with some of my interface partners they indicate that they are just not sending IN1 segments. The problem is, this is the same result for patients who just haven't entered insurance information for the patient.

    So what is the best recommended way to handle this?

  • #2
    found this online...

    http://njii.com/wp-content/uploads/2...cations-v1.pdf




    IN1-1 Set ID – IN1
    This is the ordinal number of this occurrence of the AL1 segment within the current
    message instance. The first occurrence is labeled 1, the second 2, and so on.
    If the patient is paying out of pocket rather than using insurance, then, in the first
    occurrence of the IN1 segment, the term SELF-PAY must appear in the second
    component of IN1-2-Insurance Plan ID. This is necessary to suppress the sending of
    message information to insurance carriers.

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    • #3
      Originally posted by offbyone View Post
      I am using Mirth for various HL7 interfaces. I am currently implementing a new one and an interesting issue appeared.
      How are people communicating self pay patients?

      Is there a proper way to do this in HL7?
      The IN1 segment doesn't seem appropriate as so many required fields don't fit. In speaking with some of my interface partners they indicate that they are just not sending IN1 segments. The problem is, this is the same result for patients who just haven't entered insurance information for the patient.

      So what is the best recommended way to handle this?
      Interesting implementation. I don't know then how you deal with all the other IN1 required fields. It would be hard to enforce validation if you have to open up the rest of it.

      All my interface partners use that IN1-2 as an internal unique identifier and only use the IN1-2.1 field.

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