Insurance statements?

[dipper]

Is a ncp respsonible for sending copies of insurance statements to the cp if the ncp is the insurance carrier?

[msjanbo]

Check your divorce papers to see if there's a clause stating this.  Normally, however, you DON'T have to send the EOB's if you don't wish to.  I wouldn't understand why you wouldn't want to however, unless you're trying to hind something from the CP?  The EOBs (Expl of Benefits from the Ins Carrier - showing total charges and payments made) would help in assisting both the CP and NCP to determine their share of the balance due.  Just a thought!

[4honor]

If the NCP gets the EOBs and the CP is "balking" at what the NCP is paying based on their portion of uncovered costs as stated on the EOBs, I would make a copy, redact (white out) any personal information (SSNs or other info the ex shouldn't have glaring in their face) and forward the redacted copy to the ex along with a BRIEF explanation as to why you are making the payments as you are, in an effort to resolve the matter at the lowest level of conflict.

If, however, the CP is just demanding a copy because they want what they want, remember you do not have to forward that information.

[dipper]

 "If, however, the CP is just demanding a copy because they want what they want, remember you do not have to forward that information."

This is it!  I dont believe there is anyway she could use the ins. stmts. to hurt us....I mean for one thing, If we were trying to hide something, we just wouldnt send the thing we were trying to hide.  DH has always been the insurance carrier and this has never been asked for before.....  But, since dh started asserting his rights to have bills instead of just demands for money written on paper with no proof - bm sent a letter saying that  "I would also like COPIES of ANY & ALL medical bills received from the hospitals, the doctors & offices and bills that have been paid by (ins. company), as you are the policy holder and that makes you responsible for sending them to me."    

Yes, he is the one who pays for the insurance and he is the one who pays 75% of the bills, so what is it she really needs?!  

How can there be anything to hide when she is the one billing us?  She receives the bills so its not like we can 'bill' her for above the amount left after ins>>>>

Thank you!

[VaBeachStepmom]

I'm not sure if I'm reading this right, so please correct me if I'm wrong.  Your husband provides the insurance and then pays 75% of whatever is not covered by insurance.  Is this correct?  If it is, that would leave BM responsible for the other 25% right?  I could see why she would want a copy of the actual bills.  Just like you do not want to just take her word for money you owe her, you want proof.  

If I am off base, and she doesn't pay any portion of the uninsured bills and just wants a copy of all EOB's because she's being difficult and controlling (I feel your pain there!), I would just send them.  Like you stated, it's not like you have anything to hide.  She's demanding this because she thinks it's going to ruffle your feathers and start a fight.  Imagine the look on her face when you say, sure, no problem.  We'll send it out to you tomorrow.  It's just one of those, pick your battles things.  Sure, she may be off base for demanding such things, but why let it bother you?  Just give it to her.  :-)

[KAY]

I think you should provide copies of insurance statements as you recieve them because when the new HIPPA regulations kicked in a few years ago I as a CP can not call to get insurace info reguarding payments or policy coverage since I am not the insured.  

I have no way to verify how much the insurace has paid and no way to dispute coverage on my own.  The NCP in my case won't send his insurance company a note that says I have permission to call regarding my son or provide me with statements.  But it is me who is ultimately responsible for the bill at the doctors office and they threaten me when the bill isn't paid not him.  

In the past I had a billing dispute with the doctor and I had to go to court to have insurace statements turned over to me from the NCP so I could prove the doctor didn't reduce his fee per the ppo agreement.  No one should have to do that.

[wendl]

What an idiot.

You get the EOB and the CP gets the bills. The bills SHOW what the insurance company pays so why the hell does she need the EOB.



**These are my opinions, they are not legal advice**

[dipper]

We responded by sending 75% of medications and doctor bill....but refusing the bandages of which she purchased next to $200 worth and used about 4 bandages - if that.  We also refused to pay for one receipt that had no explanation as to what the items were.

As for insurance stms., we put that there was no legal or financial obligation by her to the insurance co. and therefore, dh had no responsibility to turn them over.  The insurance stmts do not require any action from her....We also put that the bills would show what had been paid by insurance and since dh would receive copies, he would question any discrepancies between the statements and bill.

I think she knows that after the deductible is met, there will be no bills..and she just wants to see how much all of this is seriously costing - she would get a kick out of it.....For example, there was a stmt. yesterday - just for surgery - it was over $30,000....the plan with the hospital allowed for over $10,000...and the insurance co. paid the entire thing as they have already taken the yearly deductible from the $50,000 hospital bill.........yes, ss' hospital bills would be close to $100,000 if it werent for insurance!!!  The insurance co. is paying $40,000 already - and that is just one hospital.  He went to another and that bill was $4,000......and then he was transferred.....

We are reporting the situation to insurance.  Maybe they will go after these people to recover some of this money - dh has only had this insurance since March '05........He has paid in about $700, and they have put out over $40,000..........

[dipper]

AS dh is the one who pays the insurance and the majority (75%) of bills, that is not going to happen.  DH has been taken to court and garnished for as little as $100 in unpaid medical to the ex.  He will receive copies of the bills and he will receive bills directly from the hospital once they actually start billing, so there is no way he would let them bill for extra.  

I understand what you have went through, but dh isnt like your ex.  In fact, its just the reverse around here - bills for things that arent used and such......

And..she did call and talk to dh's insurance - we are figuring she pretended to be me.......

We may send her copies - there is no responsibility to do so, as she stated.........if we send them, it will be because we want to.  Believe me, we live a nightmare with this woman.  Until dh and I married, he was forced to pay demands for money written on paper, without ever knowing who they were for or what was done.....

[wendl]

Well if BM is pretending to be you to DH's insurance, have DH call them and only allow a person to talk about the insurance IF they know the secret code, I do this with everything, and most companies are pretty accepting about this.

**These are my opinions, they are not legal advice**