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Extrodinary Medecal expenses

Started by RCD, Dec 19, 2005, 07:22:43 PM

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RCD

Hello Soc,

     Thank you in advance for your time.  State with jurisdiction is Michigan.  Issue is extraordinary health care expenses (dental in this case).

     Present order apportions payment for actual out of pocket responsibility for extraordinary health care expenses as Defendant (non custodial) 39% and Plaintiff (custodial) 61%.

     Child underwent orthodontic procedure.  Doctor billed each party separately.  Defendant was billed and paid 905.82 and plaintiff was billed and paid 992.50.  Subsequent to billing and payments, health care provider realized an error they made.  Said error was under billing health insurance company.  Provider has requested additional entitlement from insurance carrier in the amount approximating $233.

     Based on actual payments, defendant paid $165.48 over that which is established by the court order.  Note defendant was threatened with collections if the specified amount of 905.82 was not paid to the provider.

     Child required a root canal procedure durring orthodontic treatment.  Plaintiff paid entire amount of bill.  Plaintiff then submitted the uncovered expenses to defendant for reimbursement.  Defendant obligation (according to plaintiff and amount is not in dispute) amounted to 162.35.

     Defendant is stating that the overpayment to the first health care provider offsets the obligation to the second provider and the two amounts produce a small (3.13) credit to the defendant.

     Plaintiff asserts that the two matters are separate and is demanding payment forthwith.


Who is correct the plaintiff or the defendant?


Thank you in advance for your input

RCD


Note: these are not really big dollars, however, defendant lost employment and successfully defended against income imputation sought by plaintiff, and at this point, 160 dollars might as well be 160,000.  

socrateaser

OK, well you're definitely not an accountant, but after laying it out in Excel(r), what I see is:

1. The original total bill: 1898.82
2. P's portion: 1898.82 x 0.61 = 1157.98
3. D's portion: 1898.82 x 0.39 = 740.34
4. P paid: 992.5; balance due: 165.48
5. D paid: 905.82; credit due: 165.48
6. Dentist overbilled 233
7. P's portion of credit: 233 x 0.61 = 142.13; subtract from 165.48 due = balance due: 23.35
8. D's portion of credit: 233 x 0.39 = 90.87; add to 165.48 credit = 265.35 credit due

Therefore, per the court orders, either P owes Dentist $23.35 and Dentist owes D $256.35, OR alternatively, Dentist owes D $233.00, and P owes Dentist $0.00.