Medical bills / Problems spliting half

[heather2662]

Illinois Residence

Divorce was final Oct. 2003.

Marital Settlement Agreement states:
Wife shall maintain on behalf of the minor children of the parties medical insurance as long as it is available through her employment. Each of the parties agrees to pay one half (1/2) of all medical, dental, optical, pharmaceutical, orthodontial, and psychological expenses of the minor children of the parties not covered by that insurance.

As of Dec. 2004 Ex-wife is not employed. I believe that Ex-wife’s current husband may add or have added the kids to his insurance. I have not been informed of this by Ex-wife. This info came from a non related party familiar with both of us.

Problem:
From the moment the “one half” medical judgment became active,

1. Ex -wife has not provided medical billing information in a timely manner. She will hold on to bills that have only my portion due for several months before sending them to me. She has also waited until they are in collection.

2. She will bring the kids back to physicians for repeat visits before I am finished paying (my half) and will try to get me to pay half on the “total bill.” (That includes her unpaid portion)

3. She has provided me with bills (for my half) that the insurance has not finished paying on . She also has been reimbursed by the insurance and kept the check.

4. She will send me non-detailed bills with hand written notes on the pages or with post-its, with her calculations of what my half is.


Questions:
1. Is there a time limit on how long Ex-wife has to provide me with true and correct bills that reflect my portion?

2. Is there a time limit to provide me with bills, where after said time, I am not responsible to pay?

3. If  my Ex-Wife’s husband adds the kids to his insurance, does she have to notify me that the kids are covered again?    
(In this case, how can I defend myself from the Ex-wife providing me with basic bills that state the total and do not reflect the insurance “I am supposedly not aware of?” Example: She gives me a bill that shows a $200.00 total and says my portion is $100.00, but insurance paid on the bill making it $30.00 dollars we are suppose to split and she pockets the money.

In addition:
I have tried to work with physicians offices directly by informing them of the (one half) payment arrangement and it has been unsuccessful to date. They do not feel it is their responsibility to keep track of separate parent billing and make no efforts to aid the situation.

Thank you,
Mark

[socrateaser]

>Questions:
>1. Is there a time limit on how long Ex-wife has to provide me
>with true and correct bills that reflect my portion?

If your wife is charging you for half of the medical bill and then secreting back an insurance payment, in order to obtain a greater benefit, that would be a fraud, and you could sue her for it and obtain restitution of the amounts owed you, plus punitive damages to encourage her not to repeat this behavior in the future.



>
>2. Is there a time limit to provide me with bills, where after
>said time, I am not responsible to pay?

There may be, but I don't know IL law on this issue. In the absence of an IL statute or a court order about timeliness of payments, a reasonable time would be appropriate, but reasonable could be a very long time -- perhaps as much as the IL statute of limitations on a contract suit, which could be from 4-6 years.

>3. If  my Ex-Wife’s husband adds the kids to his insurance,
>does she have to notify me that the kids are covered again?  

No, but as I said, if she's double dipping and you can prove it, then that's a fraud, and you can sue her.

Well, you could send a letter to the doctor, asking him to give you a breakdown of the payment history for your child, including any insurance payments received by him/her. Then just add it all up and see if you've paid one half or not.

If the doctor resists showing you a full payment history, then you can politely inform him that if you later discover that your wife is committing a fraud on you, that you will join him in the action as an agent of your wife, unless he discloses the billing history.

I would not use this little threat until after the doctor refuses to cooperate. If you threaten first, you will just cause the MD to shut down all communication.

[LizaLou1]

Soc always has the best advice, so listen to him.  But, I wanted to share our experiences...

DH had similar problems until he took the position that he was not financially responsible for debts made by his ex. He is responsible for paying 1/2 TO the ex - not directly to the doctor.  She selects the doctor and she takes the kids in alone  (we live in a different state). Therefore, she is responsible party directly to the Doctor.  She used to tell the Doctor to send the billings directly to DH because she wanted him to pay all up front.  He never did  he'd only pay 1/2 and they stopped after he provided the divorce papers and a letter referencing Fair Debt Collections Practices Act.

I agree with the doctor that he should not be responsible for the 50/50 payment issues.  Below is part of the letter DH sent to the doctors.  They quickly saw the light and stopped billing him directly.  Or it could be the EX was so embarrased she accepted their billings. Needless to say she was furious that her crap was opened to view of a third party.

"I am not responsible for debts or obligations incurred by EX.  This is not a refusal to pay, but a notice that your claim is disputed.  Under the Fair Debt Collections Practices Act (FDCPA), I have the right to request validation of the contractual obligation, which you suggest is binding on me to pay this debt. You should also be aware that reporting such invalidated information to major credit bureaus might constitute defamation of character, as the negative marks on my credit report harm my credit and prevent me from enjoying all the benefits of good credit."  

Now DH doesn't pay his ex's demands unless and until he get the doctor's billing records FROM the ex that shows insurance payments AND the insurance company's explanation of benefits that shows what they paid.  It's important that you get the doctor's statement AFTER insurance pays because they often write-off a portion of the remaining balance.  We usually call the doctors for a 2nd copy just to compare with what the EX sent.  

Currently the ex has no sent billings in almost 2 years and we know there have been medical issues.  She loves to tell people and the kids dad doesn't pay.  We send her a letter every couple of months asking for documentation. But, no documentation - no money.   Our attorney is cool with this approach.  It would make his day if she'd sue us over this issue.

LizaLou

[LizaLou1]

Soc always has the best advice, so listen to him.  But, I wanted to share our experiences...

DH had similar problems until he took the position that he was not financially responsible for debts made by his ex. He is responsible for paying 1/2 TO the ex - not directly to the doctor.  She selects the doctor and she takes the kids in alone  (we live in a different state). Therefore, she is responsible party directly to the Doctor.  She used to tell the Doctor to send the billings directly to DH because she wanted him to pay all up front.  He never did  he'd only pay 1/2 and they stopped after he provided the divorce papers and a letter referencing Fair Debt Collections Practices Act.

I agree with the doctor that he should not be responsible for the 50/50 payment issues.  Below is part of the letter DH sent to the doctors.  They quickly saw the light and stopped billing him directly.  Or it could be the EX was so embarrased she accepted their billings. Needless to say she was furious that her crap was opened to view of a third party.

"I am not responsible for debts or obligations incurred by EX.  This is not a refusal to pay, but a notice that your claim is disputed.  Under the Fair Debt Collections Practices Act (FDCPA), I have the right to request validation of the contractual obligation, which you suggest is binding on me to pay this debt. You should also be aware that reporting such invalidated information to major credit bureaus might constitute defamation of character, as the negative marks on my credit report harm my credit and prevent me from enjoying all the benefits of good credit."  

Now DH doesn't pay his ex's demands unless and until he get the doctor's billing records FROM the ex that shows insurance payments AND the insurance company's explanation of benefits that shows what they paid.  It's important that you get the doctor's statement AFTER insurance pays because they often write-off a portion of the remaining balance.  We usually call the doctors for a 2nd copy just to compare with what the EX sent.  

Currently the ex has no sent billings in almost 2 years and we know there have been medical issues.  She loves to tell people and the kids dad doesn't pay.  We send her a letter every couple of months asking for documentation. But, no documentation - no money.   Our attorney is cool with this approach.  It would make his day if she'd sue us over this issue.

LizaLou