What should I do if I don’t have the subscriber’s name, date of birth, or address required by HIPAA?

If the HIPAA Implementation Guides require specific data elements, those elements must be included in the transaction. We can’t override HIPAA requirements. If required information is missing, the transaction will be rejected before it reaches us for processing because it won’t pass Implementation Guide edits.

To avoid this, work with your software vendor and business staff to ensure all required subscriber information is collected and maintained in your practice management system before submitting the transaction.