element -> <ePayment.InsuranceGroup>
Group Tag to hold information about the insurance company
Namespace:
http://www.nemsis.org
Type:
anonymous complexType
Content:
complex, 1 attribute, 15 elements
Defined:
locally within ePayment complexType in ePayment_v3.xsd; see XML source
Includes:
definitions of 1 attribute, 15 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.58?
</ePayment.InsuranceGroup>
Content model elements (15):
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),
ePayment.58 (in ePayment.InsuranceGroup)
Included in content model of elements (1):
ePayment (in PatientCareReport)
XML Source (w/o annotations (16); 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="CityGnisCodePayment"/>
<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.InsuranceGroupID" minOccurs="0" name="ePayment.17" type="InsuranceGroupID"/>
<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:element id="ePayment.InsuranceGroupName" minOccurs="0" name="ePayment.58" type="InsuranceGroupName"/>
</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; 15/15)
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:
 60
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:
 255
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:
CityGnisCodePayment, simple content
ePayment.13 Insurance Company City No No The insurance company's city or township used for mailing purposes. E07_06 Optional The city elements within the ePayment section have been updated to allow free text. This is important for mailing address purposes to submit claims and identify the correct payer.
Simple Content
xs:string
maxLength:
 30
minLength:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceCompanyCity" minOccurs="0" name="ePayment.13" type="CityGnisCodePayment"/>
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
Pattern:
 [0-9]{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:
InsuranceGroupID, simple content
ePayment.17 Insurance Group ID No No The ID number 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.InsuranceGroupID" minOccurs="0" name="ePayment.17" type="InsuranceGroupID"/>
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:
 60
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
"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"/>
ePayment.58
Type:
InsuranceGroupName, simple content
ePayment.58 Insurance Group Name No No The name of the patient's insurance group. Optional <comment/> <v3Changes/>
Simple Content
xs:string
maxLength:
 30
minLength:
 2
XML Source (w/o annotations (1); see within schema source)
<xs:element id="ePayment.InsuranceGroupName" minOccurs="0" name="ePayment.58" type="InsuranceGroupName"/>