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Main Forums => Father's Issues => Topic started by: Rakkasan on Oct 08, 2005, 06:53:16 AM

Title: Medical Co-payment question
Post by: Rakkasan on Oct 08, 2005, 06:53:16 AM
Does anyone have any experience or case law with the following,

1)  An ex retains medical bills until they have reach an unmanagable dollar amount and then dumped them for immediate payment?

2)  Do the courts look down upon this behavior?

3)  If she save them for 4 or 5 years do the court allow 4 or 5 years for repayment?

4)  If a court order directs her to pay provide health insurance and you are to pay half of the deductable and co-payments.... does this include dental? Or is dental seen as something that needs to be spelled out separately?

5)  If the ex get braces for a child without consulting you are you required to reimburse for those expenses since they are a) cosmetic and b) a major expense that she had, unlike a broken arm, advance notice that the expense would be incurred.

Any responses would be welcome


The Rak
Title: RE: Medical Co-payment question
Post by: smtotwo on Oct 08, 2005, 07:28:18 AM
DH's ex tried this-after she moved the kids 1000 miles away and we didn't know where they were for 3 yrs. Then moved back with
all these med bills.
Jusge did not allow old bills and told her she must submit bills to us within 14 days of receiving them.

I had the same experience with braces.  My ex had my daughter for the summer and had braces put on her teeth.  I refused to pay as tehy were cosmetic and I would not have agreed to that expense.

Jusge dismissed this as well.   He put them on he can pay for them.
Title: Old medical bills
Post by: 4honor on Oct 09, 2005, 09:13:13 AM
At a certain age, they aren't even collectable in most states. 3 in some states,. 6 in others.

Dental is usually included, but orthodontics is a crap shoot depending on medical necessity, and quality of life and the parents ability to pay  vs other necessary expenses.

If an ex has saved old receipts after a child is no longer the NCP's legal responsibility, then the final hearing is the defense...  if no bills were brought up then as "pending", then they cannot come back for it now.

If this is just the case of a vindictive ex (someone else's) who is packratting these, trying for big bucks and at the worst possible circumstances, for the NCP, I have heard several on this site who have gone through this and successfully gotten a set in stone reasonable time (30-60-90 days) depending on the way the insurance works.

If the NCP holds the insurance and receives the EOB (explanation of Benefits) then they have effectively been notified of the debt and may not get full relief in court.

The NCP should ask himself, would I have been obligated if it were presented timely? Was the treatment medically necessary for my child? Is the bill still pending to the doctor? (many get written off  or sold to a collection agency when the CP is "fired" by the doctor.) It may make a difference in court.

Personally, I would not pay without a court order saying so... like at a contempt hearing, except for those charges within the last 30-45 days or so. If you owe, you owe for the timely stuff. If nothing new, then tell her to pound sand.  she would have to have the elements to get a contempt judgement  (Dear Socrateaser). I do not see, based on the information you have given, how the ex can prevail on the issue in a contempt hearing. I would push it that far if I were in your position.

[For a full defense you will probaby need to obtain the medical bill history from the providers directly - detailed of course.  I have found as an insurance adjuster that it is easy for me to get the coded bills from ANY Doctor's office if I already have the account number (found on each bill) and speak directly to billing. This happens because when a bill is high, they will talk to anyone they think will eventually pay the bill.... so if you need more information for determination of benefits.... blah blah blah, they are faxing right away. This has happened in several different states. Tell them you need their "ICD-9 and Hick-Picks codes as well as the EOBs" and finally their bills.... makes you sound like you know what you are talking about.]
Title: RE: Medical Co-payment question
Post by: MixedBag on Oct 09, 2005, 07:19:51 PM
Rak -- you know you have to start with "What does your court order say right now?"  

1.  I would first comb the bills to make sure they were properly processed through all available insurance policies.  If they were not, and the time has passed for the insurance to do their thing, I'd make note of that and probably withhold payment on bills that fell into that category.  Then again, if your policy say has an 80/20 split (where the insurance would have picked up 80%, but it never got filed), maybe paying her 20% back would be right.  

Secondly, I'd take my time paying her back over the same period of time that she took to present the bills -- particularly if they are astronomical and pay what you can afford.  (like $50/month...??)

DH did that to his EX and the judge agreed with him.  Now she's a bit more cooperative with him about bills and our insurance coverage has increased, so the bills for us haven't been too bad.

2.  Depends on the the courts will view this is not easy to predict.  If I remember correctly, you haven't had much luck with the courts, but I still wouldn't hesitate to tell the judge that you had no idea about the bills because she took P and "ran away" or however is the right way to put it.

3.  Depends on the judge -- you know this.  That's what I would do and then if she wants her money faster, at least you can show the judge that you're working on it.  (I'm thinking about how other debtors would react -- if you owe money on say a bill, if you pay something, usually they won't fuss and take you to court because they are getting their money in the end, just not in the time THEY want.)

4.  Just asked my judge this question and medical coverage when ordered by a court usually includes medical, dental, eyes, ortho, and he wasn't sure about mental health.  Sometimes all that coverage is rolled into one policy from the employer, sometimes not.  I know both of my EX have separate policies for health and dental.  Perscriptions are sometimes handled separately too.  Eyes aren't even covered, and neither is ortho necessarily.  

So if you're ordered to pay for half of the deductible, there very well could be an annual medical deductible of $500 annually, and a separate dental annual deductible.  

5.  Again, braces are optional when it comes right down to it, but in two of the three divores we deal with, we are responsible for braces if the child needs them.  I probably could have gotten support in the third divorce as well, but thought if Dad doesn't want to do this, then it's on him.  I want this for my children (I'm the CP in this case).

If there is a huge bill due, I suggest you contact the ortho and make arrangements for payments for YOUR share of P's care.  Usually that stuff is set up on a contract for monthly installments anyways.  

Sounds like you're having fun!
Title: RE: Medical Co-payment question
Post by: Rakkasan on Oct 10, 2005, 10:39:38 PM
OK, here's the deal.  This weekend I received 35 pages of medical bills, Rx receipts, dental and orthodonic receipts.  

The court order requires the PBFH to carry health insurance and any uncovered medical and health bills are to be split 50/50.  I know I like to be optimistic so here is my take.  Since the order reads that she is to provide health insurance and then specifies that we are to split uncovered medical and health bills, I am thinking she sould have carried dental as part of the health insurance.  That being said I may not be responsible for 50% of the dental.

The next glaring item is the Rx expenses, aside from her loading Parkman with antibiotics, most of the Rx's originated with her brother a neurosurgeon in Washington state, while Parkman is in Kentucky and there are no medical bills from her brother for office visits.  :)  

I have called the DEA to ask about the legality of a Dr. prescribing meds for family members based on a diagnosis by non-medical personel.  Of course DEA was closed for todays holiday so I will try again tomorrow.

The next items are orthodonics and a surgery and physical therapy the Parkman apparently received in late 2003 / 2004.  This will need to be explained further by the PBFH, since I found in the original divorce decree that ANY NON_EMERGENCY MEDICAL EXPENSE OVER $100.00 I AM TO BE CONSULTED ON.   Since I was not consulted and the  surgery followed the physical therapy which meansit was not an emergency surgery.  I believe I shouldn't have to reimburse her for these items either.

This could possibly net me a savings of $2400.00.

We shall see how this all shakes out on Thursday.  Hopefully we will be before the Commisioner and not the bought and paid for Judge from hell.  

Thanks for all your input.

Title: RE: Medical Co-payment question
Post by: MixedBag on Oct 14, 2005, 01:35:58 PM
I would agree that if she is required to carry health insurance that dental would be included in that.  I know my order only says medical insurance but the court expects more than that.

Good luck in going after her brother and stuff with the DEA.  I wonder -- when did he get to SEE Parker -- thinking along the same lines as you.

Great line to hang your hat on considering you have such a wonderfully cooperative EX as Parker's mother.