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Medical billing question

Started by TCG, Oct 02, 2004, 04:56:11 AM

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TCG

Hey Soc!  Here's our situation:

My husband's divorce decree (Illinois) says that he is responsible for providing health insurance for his daughter (primary residence with her mother, joint physical and legal custody).  Nothing is mentioned about splitting copays or other charges.  

Since the divorce (6 years), the way they've always handled it is Mom has taken her to the doc (since she lives with her) and we've taken her to the dentist.  Each parent has been responsible for payment of respective charges - It's not something they ever discussed, just something that happened.

Since this summer, however, my husband has been getting bills from his daughter's pediatrician for when the mom took her in and didn't make payment.  We called the doc's office, and they say it's their "policy" to bill the insured.

My husband wrote a letter stating that his policy was based on a faulty assumption (that he had legal responsibility for the bill) and that in absence of a court order placing the responsibility on him, all bills should be sent to the mother, as she is the primary residential parent and she is the parent who sought treatment.  Furthermore, my husband did not sign any agreement stating that he would be responsible for charges not covered by insurance.

Our children go to the same doctor, and I know that each visit the parents are given an info sheet to check, and there is a spot on the sheet that lists the person responsible for payment of uncovered charges.  Their computer automatically places the insured's name in that section, but the opportunity is given to correct that information.  Additionally, the parent accompanying the child has to sign at the bottom stating that the above information is correct and that he/she takes responsibility for uncovered charges.

We brought this up to the doctor's office and suggested they bill the parent who accompanied the child and signed that agreement.  They are continuing to bill my husband, and his ex, who is very aware of the situation, is refusing to correct the doctor's office, stating she's all too happy to let this go on and ruin my husband's credit.


Questions:

1) What should be our next step? We do not want to have to pay an attorney to take care of this (would cost more than the bill itself), but we don't want to set precedent by paying the bill either.

2) Can this be seen as fraudulent on his ex-wife's part - she signed the document saying that all information was correct, when my husband has no court order to that effect and has never consented for being billed.

3) Can my husband legally be taken to collections given he has no legal responsibility (court order) and did not sign legal consent to be billed?

Thanks a ton in advance!!!

socrateaser

>1) What should be our next step? We do not want to have to pay
>an attorney to take care of this (would cost more than the
>bill itself), but we don't want to set precedent by paying the
>bill either.

Try to negotiate a stipulated order detailing the distribution of these expenses.

>
>2) Can this be seen as fraudulent on his ex-wife's part - she
>signed the document saying that all information was correct,
>when my husband has no court order to that effect and has
>never consented for being billed.

I have never seen the document that you are alleging was fraudulent, so I can't comment, except to say that fraud is a very tough thing to prove.


There may be (and very probably are) IL laws that cover this issue, when a court order is silent -- I don't have time to research this. However, absent such laws, parents are generally jointly obligated to pay for the necessities of their children, and as you share joint legal custody, you are likely obligated to pay for the services rendered, regardless of whether or not you signed anything. You also are entitled to contribution from your ex for one half of the bill, if you decide to pay it.


>3) Can my husband legally be taken to collections given he has
>no legal responsibility (court order) and did not sign legal
>consent to be billed?

Since you have signed nothing, there is no contract that a doctor could assign to a collection agency. The doctor could certainly take you to small claims for unjust enrichment (i.e., your child received medical care and you benefited as a consequence, therefore you should pay for the benefit received), and you could then ask the court to then join your ex as a third party defendant, so as to obtain contribution.

Once again, this is all very dependent upon IL statutes that may cover this issue, so before acting on any of my comments, you need to determine what if any statutes may alter your legal obligations.