A child is brought into a facility by the mother. The child is covered by both parents’ insurances. Which statement is true regarding the primary policy holder for the child?

The correct answer is that the father is the primary policy holder because his birthday falls first in the calendar year. In insurance terms, determining the primary policy holder for a dependent child is commonly based on the "birthday rule." This rule states that when a child is covered by both parents' insurances, the plan of the parent whose birthday comes first in the calendar year is considered the primary coverage.

This approach helps to establish a clear hierarchy for claims processing and benefits. Thus, it’s important for billing and coding specialists to be familiar with this guideline to ensure that they process claims accurately and efficiently. The presence of the mother with the child does not influence which policy is primary; it strictly adheres to the birthday rule for determining primary coverage.