The GT1 segment contains guarantor (e.g., the person or the organization with financial responsibility for payment of a patient account) data for patient and insurance billing applications.
| Seq# | Data Element Name | DataType | Usage | Vocabulary | Cardinality | Item # | Length | C.LEN | Flags |
|---|---|---|---|---|---|---|---|---|---|
GT1
|
|||||||||
1
|
Set ID - GT1 | SI | R | [1..1] | 00405 | [1..4] | |||
|
2
|
Guarantor Number | CX | O | [0..*] | 00406 | ||||
|
3
|
Guarantor Name | XPN | R | [1..*] | 00407 | ||||
|
4
|
Guarantor Spouse Name | XPN | O | [0..*] | 00408 | ||||
|
5
|
Guarantor Address | XAD | O | [0..*] | 00409 | ||||
|
6
|
Guarantor Ph Num – Home | XTN | O | [0..*] | 00410 | ||||
|
7
|
Guarantor Ph Num – Business | XTN | O | [0..*] | 00411 | ||||
|
8
|
Guarantor Date/Time Of Birth | DTM | O | [0..1] | 00412 | ||||
|
9
|
Guarantor Administrative Sex | CWE | O | [0..1] | 00413 | ||||
|
10
|
Guarantor Type | CWE | O | [0..1] | 00414 | ||||
|
11
|
Guarantor Relationship | CWE | O | [0..1] | 00415 | ||||
|
12
|
Guarantor SSN | ST | O | [0..1] | 00416 | 11 | # | ||
|
13
|
Guarantor Date - Begin | DT | O | [0..1] | 00417 | ||||
|
14
|
Guarantor Date - End | DT | O | [0..1] | 00418 | ||||
|
15
|
Guarantor Priority | NM | O | [0..1] | 00419 | [1..2] | |||
|
16
|
Guarantor Employer Name | XPN | O | [0..*] | 00420 | ||||
|
17
|
Guarantor Employer Address | XAD | O | [0..*] | 00421 | ||||
|
18
|
Guarantor Employer Phone Number | XTN | O | [0..*] | 00422 | ||||
|
19
|
Guarantor Employee ID Number | CX | O | [0..*] | 00423 | ||||
|
20
|
Guarantor Employment Status | CWE | O | [0..1] | 00424 | ||||
|
21
|
Guarantor Organization Name | XON | O | [0..*] | 00425 | ||||
|
22
|
Guarantor Billing Hold Flag | ID | O | [0..1] | 00773 | [1..1] | |||
|
23
|
Guarantor Credit Rating Code | CWE | O | [0..1] | 00774 | ||||
|
24
|
Guarantor Death Date And Time | DTM | O | [0..1] | 00775 | ||||
|
25
|
Guarantor Death Flag | ID | O | [0..1] | 00776 | [1..1] | |||
|
26
|
Guarantor Charge Adjustment Code | CWE | O | [0..1] | 00777 | ||||
|
27
|
Guarantor Household Annual Income | CP | O | [0..1] | 00778 | ||||
|
28
|
Guarantor Household Size | NM | O | [0..1] | 00779 | 3 | # | ||
|
29
|
Guarantor Employer ID Number | CX | O | [0..*] | 00780 | ||||
|
30
|
Guarantor Marital Status Code | CWE | O | [0..1] | 00781 | ||||
|
31
|
Guarantor Hire Effective Date | DT | O | [0..1] | 00782 | ||||
|
32
|
Employment Stop Date | DT | O | [0..1] | 00783 | ||||
|
33
|
Living Dependency | CWE | O | [0..1] | 00755 | ||||
|
34
|
Ambulatory Status | CWE | O | [0..*] | 00145 | ||||
|
35
|
Citizenship | CWE | O | [0..*] | 00129 | ||||
|
36
|
Primary Language | CWE | O | [0..1] | 00118 | ||||
|
37
|
Living Arrangement | CWE | O | [0..1] | 00742 | ||||
|
38
|
Publicity Code | CWE | O | [0..1] | 00743 | ||||
|
39
|
Protection Indicator | ID | O | [0..1] | 00744 | [1..1] | |||
|
40
|
Student Indicator | CWE | O | [0..1] | 00745 | ||||
|
41
|
Religion | CWE | O | [0..1] | 00120 | ||||
|
42
|
Mother's Maiden Name | XPN | O | [0..*] | 00109 | ||||
|
43
|
Nationality | CWE | O | [0..1] | 00739 | ||||
|
44
|
Ethnic Group | CWE | O | [0..*] | 00125 | ||||
|
45
|
Contact Person's Name | XPN | O | [0..*] | 00748 | ||||
|
46
|
Contact Person's Telephone Number | XTN | O | [0..*] | 00749 | ||||
|
47
|
Contact Reason | CWE | O | [0..1] | 00747 | ||||
|
48
|
Contact Relationship | CWE | O | [0..1] | 00784 | ||||
|
49
|
Job Title | ST | O | [0..1] | 00785 | 20 | # | ||
|
50
|
Job Code/Class | JCC | O | [0..1] | 00786 | ||||
|
51
|
Guarantor Employer's Organization Name | XON | O | [0..*] | 01299 | ||||
|
52
|
Handicap | CWE | O | [0..1] | 00753 | ||||
|
53
|
Job Status | CWE | O | [0..1] | 00752 | ||||
|
54
|
Guarantor Financial Class | FC | O | [0..1] | 01231 | ||||
|
55
|
Guarantor Race | CWE | O | [0..*] | 01291 | ||||
|
56
|
Guarantor Birth Place | ST | O | [0..1] | 01851 | 100 | # | ||
57
|
VIP Indicator | CWE | O | [0..1] | 00146 | ||||
Definition: GT1-1 - Set ID contains a number that identifies this transaction. For the first occurrence of the segment the sequence shall be 1, for the second occurrence it shall be 2, etc.
Definition: This field contains the primary identifier, or other identifiers, assigned to the guarantor. The assigning authority and identifier type code are strongly recommended for all CX data types.
Definition: This field contains the name of the guarantor. Multiple names for the same guarantor may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Beginning with version 2.3, if the guarantor is an organization, send a Delete Indication value ("") in GT1-3 - Guarantor Name and put the organization name in GT1-21 - Guarantor Organization Name. Either guarantor name or guarantor organization name is required.
Definition: This field contains the name of the guarantor's spouse. Multiple names for the same guarantor spouse may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Definition: This field contains the guarantor's address. Multiple addresses for the same person may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Definition: This field contains the guarantor's home phone number. All personal phone numbers for the guarantor may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated. .
Definition: This field contains the guarantor's business phone number. All business phone numbers for the guarantor may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Definition: This field contains the guarantor's date of birth.
Definition: This field contains the guarantor's gender. Refer to User-defined Table 0001 - Administrative Sex in Chapter 2C, Code Tables, for suggested values.
Definition: This field indicates the type of guarantor, e.g., individual, institution, etc. Refer to User-defined Table 0068 - Guarantor Type in Chapter 2C, Code Tables, for suggested values.
Definition: This field indicates the relationship of the guarantor with the patient, e.g., parent, child, etc. Refer to User-defined Table 0063 - Relationship in Chapter 2C, Code Tables, for suggested values.
Definition: This field contains the guarantor's social security number.
Definition: This field contains the date that the guarantor becomes responsible for the patient's account.
Definition: This field contains the date that the guarantor stops being responsible for the patient's account.
Definition: This field is used to determine the order in which the guarantors are responsible for the patient's account.
"1" = primary guarantor
"2" = secondary guarantor, etc.
Definition: This field contains the name of the guarantor's employer, if the employer is a person. When the guarantor's employer is an organization, use GT1-51 - Guarantor Employer's Organization Name. Multiple names for the same person may be sent in this field, not multiple employers. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Definition: This field contains the guarantor's employer's address. Multiple addresses for the same employer may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Definition: This field contains the guarantor's employer's phone number. Multiple phone numbers for the same employer may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated. .
Definition: This field contains the guarantor's employee number. The assigning authority and identifier type code are strongly recommended for all CX data types.
Definition: This field contains the code that indicates the guarantor's employment status. Refer to User-Defined Table 0066 - Employment Status in Chapter 2C, Code Tables, for suggested values.
Definition: This field contains the name of the guarantor when the guarantor is an organization. Multiple names for the same guarantor may be sent in this field, not multiple guarantors. .Specification of meaning based on sequence is deprecated
Beginning with version 2.3, if the guarantor is a person, send a Delete Indication value ("") in GT1-21 - Guarantor Organization Name and put the person name in GT1-3 - Guarantor Name. Either guarantor person name or guarantor organization name is required.
Definition: Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, Code Tables, for valid values. This field indicates whether or not a system should suppress printing of the guarantor's bills.
Y a system should suppress printing of guarantor's bills
N a system should not suppress printing of guarantor's bills
Definition: This field contains the guarantor's credit rating. Refer to User-defined Table 0341 - Guarantor Credit Rating Code in Chapter 2C, Code Tables, for suggested values.
Definition: This field is used to indicate the date and time at which the guarantor's death occurred.
Definition: This field indicates whether or not the guarantor is deceased. Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, Code Tables, for valid values.
Y the guarantor is deceased
N the guarantor is living
Definition: This field contains user-defined codes that indicate which adjustments should be made to this guarantor's charges. For example, when the hospital agrees to adjust this guarantor's charges to a sliding scale. Refer to User-defined Table 0218 - Patient Charge Adjustment in Chapter 2C, Code Tables, for suggested values.
Example: This field would contain the value used for sliding-fee scale processing.
Definition: This field contains the combined annual income of all members of the guarantor's household.
Definition: This field specifies the number of people living at the guarantor's primary residence.
Definition: This is a code that uniquely identifies the guarantor's employer when the employer is a person. It may be a user-defined code or a code defined by a government agency (Federal Tax ID#).
When further breakdowns of employer information are needed, such as a division or plant, it is recommended that the coding scheme incorporate the relationships (e.g., define separate codes for each division). The assigning authority and identifier type code are strongly recommended for all CX data types.
Definition: This field contains the marital status of the guarantor. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.
Definition: This field contains the date that the guarantor's employment began.
Definition: This field indicates the date on which the guarantor's employment with a particular employer ended.
Definition: Identifies the specific living conditions of the guarantor. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.
Definition: Identifies the transient state of mobility for the guarantor. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested values.
Definition: This field contains the code to identify the guarantor's citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables.
Definition: This field identifies the guarantor's primary speaking language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language defined in Chapter 2C, Code Tables.
Definition: This field identifies the situation in which the person lives at his residential address. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.
Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for a guarantor. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.
Definition: This field identifies the guarantor's protection, which determines whether or not access to information about this enrollee should be restricted from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/no Indicator for valid values.
Y restrict access
N do not restrict access
Definition: This field indicates whether the guarantor is currently a student, and whether the guarantor is a full-time or part-time student. This field does not indicate the degree level (high school, college) of the student, or his/her field of study (accounting, engineering, etc.). Refer to User-defined Table 0231- Student Status in Chapter 2C, Code Tables, for suggested values.
Definition: This field indicates the type of religion practiced by the guarantor. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.
Definition: This field indicates the guarantor's mother's maiden name.
Definition: This field contains a code that identifies the nation or national grouping to which the person belongs. This may be different from a person's citizenship in countries in which multiple nationalities are recognized (for example, Spain: Basque, Catalan, etc.). HL7 recommends using ISO table 3166 as suggested values in User-defined Table 0212 - Nationality in Chapter 2C, Code Tables.
Definition: This field contains the guarantor's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.
Definition: This field contains the name of the person who should be contacted regarding the guarantor bills, etc. This may be someone other than the guarantor. (E.g., Contact guarantor's wife regarding all bills - guarantor lives out of country.)
This is a repeating field that allows for multiple names for the same person. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Definition: This field contains the telephone number of the guarantor (person) to contact regarding guarantor bills, etc. Multiple phone numbers for that person may be sent in this sequence. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.
Definition: This field contains a user-defined code that identifies the reason for contacting the guarantor, for example, to phone the guarantor if payments are late. Refer to User-defined Table 0222 - Contact reason in Chapter 2C, Code Tables, for suggested values.
Definition: Identifies the guarantor relationship to the contact person specified above. Refer to User-defined Table 0063 - Relationship in Chapter 2C, Code Tables, for suggested values. Examples include wife, attorney, power of attorney, self, and organization.
Definition: This field contains a descriptive name of the guarantor's occupation (e.g., Sr. Systems Analyst, Sr. Accountant).
Definition: This field contains the guarantor's job code and employee classification.
Definition: This field contains the name of the guarantor's employer when the guarantor's employer is an organization. When the guarantor's employer is a person, use GT1-16 - Guarantor Employer Name. Multiple names for the same guarantor may be sent in this field Specification of meaning based on sequence is deprecated.
Definition: This field contains a code to describe the guarantor's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.
Definition: This field contains a code that identifies the guarantor's current job status. Refer to User-defined Table 0311 - Job Status in Chapter 2C, Code Tables, for suggested values.
Definition: This field contains the financial class (FC) assigned to the guarantor for the purpose of identifying sources of reimbursement. It can be different than that of the patient. When the FC of the guarantor is different than the FC of the patient, and the guarantor's coverage for that patient has been exhausted, the source of reimbursement falls back onto the FC of the patient.
Definition: This field refers to the guarantor's race. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.
Definition: This field contains the description of the guarantor's birth place, for example "St. Francis Community Hospital of Lower South Side." The actual address is reported in GT1-5 – Guarantor Address with an identifier of "N".
Definition: This field identifies the type of VIP for the guarantor. Refer to User-defined Table 0099 – VIP Indicator in Chapter 2C, Code Tables, for suggested values.
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