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Podiatry Coding & Billing Alert

Reader Question:

Pay Attention to Month, Not Year, With Birthday Rule

Published on Fri Feb 10, 2012

Question: I just received a call from a patient's parent claiming that we didn't follow the birthday rule when we billed the mother's insurance. The mother's birthday is 09/30/1965 and the father's birthday is 11/30/1958. The mother says that since the father is older, we should have billed his insurance rather than hers. What is the birthday rule and whose insurance should we have billed?Iowa SubscriberAnswer: You'll only follow the "birthday rule" in determining which parent's insurance is primary when the child is covered under the insurance plans for both parents. You'll find this rule typically applies to children whose parents are not separated or divorced, or dependent children of parents with joint custody.How it works: The birthday rule says that for a dependent child of parents who are not legally separated or divorced, the insurance of the parent whose birthday falls earlier in the year is the primary payer.The [...]
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