How Do You Handle Coordination of Benefits When Patients Have Multiple Insurance Policies?

Coordination of benefits (COB) determines which insurance pays first (primary) and which pays second (secondary). The birthday rule typically determines order for dependent children, with the parent whose birthday falls earlier in the calendar year being primary. For spouses, each person’s own insurance is usually primary for themselves. Claims must be submitted to the primary payer first, then the secondary payer receives the claim with the primary payer’s EOB. Improper COB filing causes delays and denials, so verifying correct payer order before billing is essential.