Welcome to SPARC Forums. Please login or sign up.

Dec 21, 2024, 06:53:53 AM

Login with username, password and session length

insurance issue with bio dad and 50 % of medical bills never paid

Started by balleros, Feb 14, 2015, 03:44:05 PM

Previous topic - Next topic

balleros

My ex had paid zero bills from 2014 and by court order, he shouold pay 50 %.
The biggest issue I have right now is with out of network expenses that I paid. Any help on this? here is the situation:
My son receives weekly medical sessions. His dad and I have no parenting plan and no custody so techincally speaking, he may ask about services my son gets and I would respond but he never inquiries. I do keep him posted but he never responds so he has no saying now in questioning this.
Out of all the sessions I paid in 2014, I sent a claim to his insurance (which is primary for my son)  after checking with them what they allowed us to do. I knew I had 70 % reimbursement. So I gather the 5 bills from 2014 and I sent the claim. it weas processed right away and they issued a check for $ 500 that they sent electronically to him, the insuranced person. I understand that, no complaints. I told him that he was going to receive the money. When I knew it was done, I asked him to please check his mail and he said he had not received anything. I called the insurance to see if they could send it to the provider and they told me : (1) no, (2) the check was sent electronically and then yes, I was furious.
I sent an email again and I told him that I can't afford more session unless I start getting something back and I told him that rgardless of the money (which could have been lost and he might have to ask them to re issue a check) , I needed the explanation of benegits (which was online) so that I could forward a cliam to my insurace for the remaining balance. It took him 10 days to send that to me and he finally did it late on friday and with the long weekend, I wont be able to send it until Tuesday 18th. I might have to stop my on's treatment un til some money comes back.It is not life threatening so i wont get a court order.
The issue is that this will be on going for at least 6 months.I would hate to kkeep fighting about this.
I am also trying not to spend money on an attorney
how bad would it look if I write a letter to his attorney?
any other option?
FYI, I have never used name calling or anything crazy so he can't accused me of anything. I have not called him or bothered him in any way.
he received a certified letter from me explaning all this.
Also, if he doesnt reimburse me for anything, I guess my other option is sending him all bills for him to pay his 50 % but I would still get less money than going through primary and secondary insurance



this is out of network.I payed upfront. it is not a dr billing the insurance.it is a dr billing me, i pay at the end of each session. The 500 reimbursement is for 2014 and I just submitted a claim for $ 850 and I should get a 70 % of that. I  send all claims to his  insurance gives me 70 %. I also need from bio dad the explanation of benefits so that I can send the claim to my insurance. Basically if he would collaborate, I would end up paying a % 5

MixedBag

deleted

MixedBag

And yes, if they sent it to the insured....then I'd be bugging the insured AND the insurance company to get the money, on a monthly basis and after 2 months, file with the court to force the issue.

Can you get the EOB from the doctor's office after Dad's insurance pays?  I used to have to do that because I had a "wonderfully uncooperative" EX too.

And don't make threats -- because if you make one, you HAVE to follow through or else you loose credibility on future issues.