Non-networked service providers..

[leftoverinmn]

Hi guys! Has anyone gone through this before:

CO states that DH is responsible for 100% uninsured costs. He is also ordered to provide medical insurance. However, PBFH has been taking the children to doctors/dentists/orthodontists that are not in the provider's network for insurance coverage.  i.e.. They are not covered by the insurance that he provides, and he has to pay the bills..

I'm beginning to think that she is doing this on purpose, just to bleed him dry.

His insurance will cover braces for the kids, but she found one that won't take his insurance. So now he's getting medical bills, on top of his CS payments. Is the only way to fix this going back for a modification??

Or does he have the right to refuse care given by these doctors.. The doctors send the bills directly to him, it doesn't go through the CS office. Can he call the doc and say "blow it out your a$$, I'm not paying this, don't take anymore visits from my kids"????
 

[KAT]

The doctors can not bill a 3rd party. Send the bill back & request a copy of the forms showing his signature requesting treatment for the minor child(ren) AND a copy of his signature guaranteeing payment. Personally, I wouldn't pay them; they can NOT bill you so they can't sue you either. They can send it to collections but the bills CAN NOT be verified so there isn't diddly they can do there either.  Send HER information (address, social security number ect.) to the doctors. After obtaining a copy (if they even send it, I've never had one do so) send a copy to biomom simply stating that what she is doing could be considered fraud, forgery and possible identity theft. Criminal charges could be filed. I would also make it clear that she has been provided insurance cards and that failing to take the child(ren) to network provider's means that she agrees to pay 100% for the treatment provided. If she doesn't agree then you guess the judge will decide. Once in court request that she be held responsible for the first $250.00 per year of the unpaid medical then 50% there after in addition make sure it is written in the order that she is to provide copies of the PAID bills within 30 days of treatment.  If your husband wasn't awarded the tax exemption then this is a good time to ask for it (bring the IRS form for her to sign in front of the judge.)
Sorry, I wouldn't let her get away with this. Ours did so for many years until I got wise to what Mr. KAT"s rights actually were. We are talking 4 g's of med bills that I paid with my own money to have them removed from his credit record NEEDLESSLY. Thsi was told to the judge who was FURIOUS at biohag.
Good Luck! (I'd file a motion to clarify & modify...save the money to pay the bills just in case the judge orders that he pay it however there is a mighty good chance that isn't going to happen at least not 100%).
KAT

[Darryl]

detailing medical costs. And most state that if child is taken to an out-of-network provider (when the same treatment is available in-network) then that person is responsible for most if not all of the expense.

As far as telling the provider that you did not sign for, or authorize the treatment etc..... GOOD LUCK!  They do not care. I was harrassed for over a year regarding medical bills that were not my responsibility. I asked for documentation with MY signature on it, none was provided. They said it does not matter. It got pretty nasty at times, accusing me of not being a good father etc. (by the collection agency). It is STILL on my credit report. They stated I was the insurance provider so it was my responsibility. No one cared what the court order stated. I never paid it! I asked them if they ever tried billing biomom since her signature was on the consent form. They said they had not and would not because I needed to pay it. I finally changed my phone number. At least I get some peace and quiet now!  :)

[KAT]

They can NOT do that, it is total b.s. First of all, you guarantee medical INSURANCE not to pay their stinking bill. Second, your court order is with the bioparent NOT with them, they are NOT a party to the court order. Mighty BIG difference!!! Ever watch that movie The Firm? How did they finally get taken down? From billing 3rd parties, mail fraud!! And yes I wouldn't hesitate to file complaints on each & every Dr. Office, hospital what have you with the Postmaster of their city. Forms are on line. Truth is, many office billing managers have no idea until they are quoted THE LAW.
Now, on to the collection agencies. They have TO VERIFY or it drops off. It really is just that simple. Of course it doesn't stop them from trying to collect but a brief certified letter takes care of that. If they break the law, sue them & yes you can do it in your state & yes it does work too. Once you notify them they MUST cease & desist.
Just remember everything goes out CERTIFIED MAIL WITH RETURN RECEIPT. Without it you have nothing.
You can find a lot of info by simply reading the discussion boards (at the top) creditinfocenter.com
Sorry, this stuff just gets me hot under the collar....grrrr!!!!
Good Luck!
KAT

[leftoverinmn]

OK, that really helps guys. But there is nothing in the CO about networked service providers.

Are orthodontic braces considered an uninsured medical expense?? (I know the kids need them) BUT, isn't it cosmetic??? After looking around on Met-life dental there is no orthodontist who takes medical insurance.

Are braces a medical expense???

[KAT]

If you have a telephone book for the area or even look them up on line it's not necessarily an orthodontist who does braces. My basic dentist does it all, oral surgery the works. See if you can find one then cert mail her. I've seen braces go both ways in court. Some kids really do need them, others it's purely cosmetic. What are they going to have us paying for next eh? Plastic surgery? Laser vision correction??
Why would you be ordered to provide health insurance if she doesn't have to use it? That doesn't make sense & I feel that her refusal is nothing but malicious, manipulative & harassing....and I'd state so in my response if she files contempt of court.
On a side note have you checked to see if your insurance company might pay something on the out of network providers if you submit them yourself? Some do.
KAT

[MixedBag]

Braces can go either way.

I believe in them, so even if it wasn't addressed, we'd support.

Medically speaking, if there is coverage its under the dental plan and then some plans don't cover it.


As far as your other problems, I agree with KAT in addressing them.

DH's EX took the kids to non-network providers and ended up with the bills.  Collection agencies came after him and we managed to get that stuff removed for the same reason.

He didn't authorize the care and the divorce was between mom and dad for bills not the doctor.  It was  along fight, but he (we) won.

Most insurance companies also process the stuff for non-network providers -- just under a different set of rules.

ALSO go see what your state's laws say.  Some have some elaborate instructions there which parents must follow.