What is “birthday rule” in medical billing?

Birthday Rule in Medical Billing

The birthday rule is a guideline used to determine which parent’s insurance is primary when a dependent child is covered by both parents’ health insurance plans.

Birthday Rule in Medical Billing Explained

According to the birthday rule, the health insurance plan of the parent whose birthday falls earlier in the calendar year is considered the primary insurance for the child. The other parent’s plan becomes the secondary insurance. This rule simplifies coordination of benefits for dependent children.

For example, if the mother’s birthday is in March and the father’s birthday is in July, the mother’s insurance will be the primary payer for the child.

Check acronyms and abbreviations in Medical billing glossary.

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