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birthday rule

  1. Default birthday rule
    Medical Coding Books
    where would I find the birthday rule to send with claims to get paid. aetna doesnt want to pay because the parents have not called them to tell who is primary and who is secondary

  2. #2
    Insurance companies are well aware of the birthday rule. I have found that they will not update any COB information until they get a call from the parents to give them all the information regarding both insurance carriers. Until then you will have trouble with both carriers. I suggest a call or letter to the parents to get them to call their carriers and update both of them. Hope that helps.

  3. #3
    Milwaukee WI
    Default Bill the parents
    When we get a "denial" for additional information pending," we wait one billing cycle for patient/parents to contact insurance. Then we send the patient/parent the bill.

    We've found if we send the bill to the parents they get on the phone with their insurance company pronto.

    Hope that helps.

    F Tessa Bartels, CPC, cEMC

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