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  1. #1
    TxFatherSupport is offline Junior Member
    Join Date
    Oct 2009
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    Dallas, Tx
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    Unreimbursed Medical Expenses in Texas

    What is the name of your state (only U.S. law)? Texas

    I pay child support for my two children, along with requirements to pay 100% of all unreimbursed medical expenses, while she is to pay for medical insurance. The decree states that I must pay support and unreimbursed medical expenses for each child until they reach 18 years of age, or until the end of the month in which they graduate from high school, whichever is later.

    My daughter turned 18 in March, and actually began college in January. Based on this, my support would have ended at the end of March. However, since my daughter had not actually received her high school diploma, I could not stop support until the diploma had not been received. Due to the large amount of college credit received in high school, she had spent the fall of 2008 home schooled to complete the remaining high school requirements. However, it was June 8, 2009 when she finally received her diploma - supposedly she was not able to take the tests until that time to complete the home schooling. I do have an actual copy of the diploma.

    Here are my two questions / issues: First, my daughter had to have a root canal performed in early April due to an abcessed tooth which had been left untreated for too long (I have no say in all this - parental alienation is involved so I do not get to see my children per court order. Judge recognized the alienation, but decided not to do anything more to try to change things). The tooth had to have a root canal, a build up, trimming, a second root canal and finally the crown itself - totaling just over $4000. Her mother has insurance which paid for part, and I have dental as well, which has paid a great deal of the rest. She then had three fillings done the beginning of May, and 4 fillings done the beginning of June. In addition, I have found out that the first root canal was never completed, and for which she was completely reimbursed (just about $1300, and I reimbursed her for what insurance didn't pay of about $250) and my daughter had to go to a specialist to have a second root canal done at a cost of over $1700. The second root canal was in August 2009, over a month after my unreimbursed medical expenses obligation ended. She is saying I owe her for the difference on the root canal because the root canal was in process. I say that I do not. Thoughts?

    In addition to this, and through all the secondary insurance filings with my carrier, I have found that though the CP did have dental insurance, it was not accepted by the dentists office. They would file, but would charge full price rather than reasonable and customary. Yet at this point, I have payed the unreimbursed portion of the full price. I do not feel that I should have to do that. Is there anything I can fall back on as to precedence which states that I only have to pay reasonable and customary? My insurance did calculate based on reasonable and customary, though hers did not. Unfortunately, though, the dentist's office does not accept the secondary, and therefore won't recognize my insurances reasonable and customary charges.

    Again, thoughts on this? The decree / order does state reasonable and customary, but not sure how far that actually goes when it comes down to the actual charges and whether reasonable and customary can be determined based on what the insurance company claims is reasonable and customary.

    Thx,
    TxFatherSupport
  2. #2
    the _dude is offline Junior Member
    Join Date
    Oct 2009
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    6
    I'd say you're done with the dental bills after the diploma date- her mom should have assured that these were finished by then. If her mom wants to hire a lawyer and sue you, that's her money down the drain.
    The insurance battle will probably wind up with you and them settling on a compromise, offer to split the difference and they'll usually go for it. It's not worth messing up your credit report.

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