element -> <ePayment.InsuranceGroup>
Group Tag to hold information about the insurance company
Namespace:
http://www.nemsis.org
Type:
anonymous complexType
Content:
complex, 1 attribute, 14 elements
Defined:
locally within ePayment complexType in ePayment_v3.xsd; see XML source
Includes:
definitions of 1 attribute, 14 elements
Content Model Diagram
XML Representation Summary
<ePayment.InsuranceGroup
    CorrelationID
 = 
 xs:string
    >
   
Content: 
 ePayment.09?, ePayment.10?, ePayment.11?, ePayment.12?, ePayment.13?, ePayment.14?, ePayment.15?, ePayment.16?, ePayment.17?, ePayment.18?, ePayment.19?, ePayment.20?, ePayment.21?, ePayment.22?
</ePayment.InsuranceGroup>
Content model elements (14):
ePayment.09 (in ePayment.InsuranceGroup),
ePayment.10 (in ePayment.InsuranceGroup),
ePayment.11 (in ePayment.InsuranceGroup),
ePayment.12 (in ePayment.InsuranceGroup),
ePayment.13 (in ePayment.InsuranceGroup),
ePayment.14 (in ePayment.InsuranceGroup),
ePayment.15 (in ePayment.InsuranceGroup),
ePayment.16 (in ePayment.InsuranceGroup),
ePayment.17 (in ePayment.InsuranceGroup),
ePayment.18 (in ePayment.InsuranceGroup),
ePayment.19 (in ePayment.InsuranceGroup),
ePayment.20 (in ePayment.InsuranceGroup),
ePayment.21 (in ePayment.InsuranceGroup),
ePayment.22 (in ePayment.InsuranceGroup)
Included in content model of elements (1):
ePayment (in PatientCareReport)
XML Source (w/o annotations (15); see within schema source)
<xs:element id="ePayment.InsuranceGroup" maxOccurs="unbounded" minOccurs="0" name="ePayment.InsuranceGroup">
<xs:complexType>
<xs:sequence>
<xs:element id="ePayment.InsuranceCompanyID" minOccurs="0" name="ePayment.09" type="InsuranceCompanyID"/>
<xs:element id="ePayment.InsuranceCompanyName" minOccurs="0" name="ePayment.10" type="InsuranceCompanyName"/>
<xs:element id="ePayment.InsuranceCompanyBillingPriority" minOccurs="0" name="ePayment.11" type="InsuranceCompanyBillingPriority"/>
<xs:element id="ePayment.InsuranceCompanyAddress" minOccurs="0" name="ePayment.12">
<xs:complexType>
<xs:simpleContent>
<xs:extension base="StreetAddress">
<xs:attribute name="StreetAddress2" type="StreetAddress" use="optional"/>
</xs:extension>
</xs:simpleContent>
</xs:complexType>
</xs:element>
<xs:element id="ePayment.InsuranceCompanyCity" minOccurs="0" name="ePayment.13" type="CityGnisCode"/>
<xs:element id="ePayment.InsuranceCompanyState" minOccurs="0" name="ePayment.14" type="ANSIStateCode"/>
<xs:element id="ePayment.InsuranceCompanyZIPCode" minOccurs="0" name="ePayment.15" type="ZIP"/>
<xs:element id="ePayment.InsuranceCompanyCountry" minOccurs="0" name="ePayment.16" type="ANSICountryCode"/>
<xs:element id="ePayment.InsuranceGroupIDName" minOccurs="0" name="ePayment.17" type="InsuranceGroupIDName"/>
<xs:element id="ePayment.InsurancePolicyIDNumber" minOccurs="0" name="ePayment.18" type="InsurancePolicyIDNumber"/>
<xs:element id="ePayment.LastNameoftheInsured" minOccurs="0" name="ePayment.19" type="PersonLastName"/>
<xs:element id="ePayment.FirstNameoftheInsured" minOccurs="0" name="ePayment.20" type="PersonFirstName"/>
<xs:element id="ePayment.MiddleInitialNameoftheInsured" minOccurs="0" name="ePayment.21" type="PersonMiddleName"/>
<xs:element id="ePayment.RelationshiptotheInsured" minOccurs="0" name="ePayment.22" type="RelationshipToInsured"/>
</xs:sequence>
<xs:attribute name="CorrelationID" type="CorrelationID" use="optional"/>
</xs:complexType>
</xs:element>
Attribute Detail (all declarations; defined in this component only; 1/1)
CorrelationID
Type:
CorrelationID
Use:
optional
Attribute Value
xs:string
MaxLength:
 255
MinLength:
 0
XML Source (see within schema source)
<xs:attribute name="CorrelationID" type="CorrelationID" use="optional"/>
Content Element Detail (all declarations; defined in this component only; 14/14)
ePayment.09
Type:
InsuranceCompanyID, simple content
ePayment.09 Insurance Company ID No No The ID Number of the patient's insurance company. E07_03 Optional This element should be used as the Health Plan ID (HPID) field in X12. It is currently under development for X12 and will be a future release.
Simple Content
xs:string
maxLength:
 60
minLength:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyID" minOccurs="0" name="ePayment.09" type="InsuranceCompanyID"/>
ePayment.10
Type:
InsuranceCompanyName, simple content
ePayment.10 Insurance Company Name No No The name of the patient's insurance company. Optional
Simple Content
xs:string
maxLength:
 100
minLength:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyName" minOccurs="0" name="ePayment.10" type="InsuranceCompanyName"/>
ePayment.11
Type:
InsuranceCompanyBillingPriority, simple content
ePayment.11 Insurance Company Billing Priority No No The billing priority or order for the insurance company. E07_04 Optional
Simple Content
enumeration of xs:string
Enumeration:
"2611001"
 - 
 Other
"2611003"
 - 
 Primary
"2611005"
 - 
 Secondary
"2611007"
 - 
 Tertiary
"2611009"
 - 
 Payer Responsibility Four
"2611011"
 - 
 Payer Responsibility Five
"2611013"
 - 
 Payer Responsibility Six
"2611015"
 - 
 Payer Responsibility Seven
"2611017"
 - 
 Payer Responsibility Eight
"2611019"
 - 
 Payer Responsibility Nine
"2611021"
 - 
 Payer Responsibility Ten
"2611023"
 - 
 Payer Responsibility Eleven
"2611025"
 - 
 Unknown
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyBillingPriority" minOccurs="0" name="ePayment.11" type="InsuranceCompanyBillingPriority"/>
ePayment.12
Type:
anonymous (extension of StreetAddress), simple content
ePayment.12 Insurance Company Address No No The mailing address of the Insurance Company E07_05 Optional
Simple Content
xs:string
maxLength:
 55
minLength:
 1
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyAddress" minOccurs="0" name="ePayment.12">
<xs:complexType>
<xs:simpleContent>
<xs:extension base="StreetAddress">
<xs:attribute name="StreetAddress2" type="StreetAddress" use="optional"/>
</xs:extension>
</xs:simpleContent>
</xs:complexType>
</xs:element>
ePayment.13
Type:
CityGnisCode, simple content
ePayment.13 Insurance Company City No No The insurance company's city or township used for mailing purposes. E07_06 Optional City codes are based on GNIS Feature Class. The primary Feature Class to use is ""Civil"" with ""Populated Place"" and ""Military"" code as additional options. <br/><br/>Definitions for each GNIS City Feature Class can be found on the GNIS Codes website. <br/><br/>GNIS Codes Website: <a>http://geonames.usgs.gov/domestic/download_data.htm</a>
Simple Content
xs:positiveInteger
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyCity" minOccurs="0" name="ePayment.13" type="CityGnisCode"/>
ePayment.14
Type:
ANSIStateCode, simple content
ePayment.14 Insurance Company State No No The insurance company's state, territory, or province, or District of Columbia. E07_07 Optional Based on the ANSI State Code.<br/><br/>GNIS Codes Website: <a>http://geonames.usgs.gov/domestic/download_data.htm</a>
Simple Content
xs:string
Length:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyState" minOccurs="0" name="ePayment.14" type="ANSIStateCode"/>
ePayment.15
Type:
ZIP, simple content
ePayment.15 Insurance Company ZIP Code No No The insurance company's ZIP Code E07_08 Optional ZIP Codes Product Website: <a>https://www.zipcodedownload.com/Products/Product/Z5Commercial/Standard/Overview/</a> <br/>Product: USA - 5-digit ZIP Code Database, Commercial Edition
Simple Content
xs:string
Pattern:
 [0-9]{5}|[0-9]{5}-[0-9]{4}|[0-9]{5}-[0-9]{5}|[A-Z][0-9][A-Z] [0-9][A-Z][0-9]
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyZIPCode" minOccurs="0" name="ePayment.15" type="ZIP"/>
ePayment.16
Type:
ANSICountryCode, simple content
ePayment.16 Insurance Company Country No No The insurance company's country Optional Based on the ISO Country Code.<br/><br/>ANSI Country Codes (ISO 3166) Website: <a>http://www.iso.org/iso/country_codes/iso_3166_code_lists.htm</a> Added to better document international addresses.
Simple Content
xs:string
Length:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyCountry" minOccurs="0" name="ePayment.16" type="ANSICountryCode"/>
ePayment.17
Type:
InsuranceGroupIDName, simple content
ePayment.17 Insurance Group ID/Name No No The ID number or name of the patient's insurance group E07_09 Optional
Simple Content
xs:string
maxLength:
 30
minLength:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceGroupIDName" minOccurs="0" name="ePayment.17" type="InsuranceGroupIDName"/>
ePayment.18
Type:
InsurancePolicyIDNumber, simple content
ePayment.18 Insurance Policy ID Number No No The ID number of the patient's insurance policy E07_10 Optional
Simple Content
xs:string
maxLength:
 30
minLength:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsurancePolicyIDNumber" minOccurs="0" name="ePayment.18" type="InsurancePolicyIDNumber"/>
ePayment.19
Type:
PersonLastName, simple content
ePayment.19 Last Name of the Insured No No The last (family) name of the person insured by the insurance company. E07_11 Optional
Simple Content
xs:string
maxLength:
 50
minLength:
 1
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.LastNameoftheInsured" minOccurs="0" name="ePayment.19" type="PersonLastName"/>
ePayment.20
Type:
PersonFirstName, simple content
ePayment.20 First Name of the Insured No No The first (given) name of the person insured by the insurance company E07_12 Optional
Simple Content
xs:string
maxLength:
 50
minLength:
 1
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.FirstNameoftheInsured" minOccurs="0" name="ePayment.20" type="PersonFirstName"/>
ePayment.21
Type:
PersonMiddleName, simple content
ePayment.21 Middle Initial/Name of the Insured No No The middle name, if any, of the person insured by the insurance company. E07_13 Optional
Simple Content
xs:string
maxLength:
 50
minLength:
 1
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.MiddleInitialNameoftheInsured" minOccurs="0" name="ePayment.21" type="PersonMiddleName"/>
ePayment.22
Type:
RelationshipToInsured, simple content
ePayment.22 Relationship to the Insured No No The relationship of the patient to the primary insured person E07_14 Optional Descriptors are consistent with X12 Loop 2000C PAT01, Specifies the patient's relationship to the person insured.
Simple Content
enumeration of xs:string
Enumeration:
"2622001"
 - 
 Self
"2622003"
 - 
 Spouse
"2622005"
 - 
 Child/Dependent
"2622007"
 - 
 Other <span style='font-size:8px;background:purple;color:white;padding:1px;'>DEPRECATED</span>
"2622009"
 - 
 Cadaver Donor
"2622011"
 - 
 Employee
"2622013"
 - 
 Life/Domestic Partner
"2622015"
 - 
 Organ Donor
"2622017"
 - 
 Unknown
"2622019"
 - 
 Other Relationship
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.RelationshiptotheInsured" minOccurs="0" name="ePayment.22" type="RelationshipToInsured"/>