Did I commit insurance fraud?
What is the name of your state? Michigan
I am wondering if this is insurance fraud and what would happen if so?
I have a Friend of the Court situtation with Dental coverage. Unless I send in bills within the year incrued to FOC they will not add them to my ex's medical file. This has happened before.
I could not find the bill from the dentist. I printed my own bill (similiar to the one I originally had) but this showing payment for services rendered. At the time, I had not yet made payment.
My dentist told me to wait until they send it in again. So therefore no out of pocket payment was made. I can not send in bills to FOC unless I make a payment after insurance has been applied. Since I did not want to miss the year window again, I sent in a proof of payment when no such had been made.
I sent this along with my EOB showing partial coverage and my ex's showing no coverage. At the time, I did have a balance owing on my account.
After this was submitted to FOC, my ex's insurance (now the correct one being billed after 7 mths) ended up denying additional coverage. The dental office wrote off the uninsured amount. I had no out of pocket expenses. Because my ex's EOB's finally went to the FOC his amount due was removed from his medical file. He paid no out of pocket expenses.
Because I sent in a statement showing I paid when I did not, is this a fraudulent claim to FOC or insurance co?
What are the consequences I could face?
Any advice on how I could handle this as I was not intentionally trying to get any money that was not due to me?
My ex knows no money has been paid by me or himself and the FOC has credited him. As far as FOC is concerned, it's over. My ex is pursing this issue as a insurance fraud claim. How he will do that I am not quite sure. I just would like to be prepared for the worse.
What is the name of your state? Michigan
I am wondering if this is insurance fraud and what would happen if so?
I have a Friend of the Court situtation with Dental coverage. Unless I send in bills within the year incrued to FOC they will not add them to my ex's medical file. This has happened before.
I could not find the bill from the dentist. I printed my own bill (similiar to the one I originally had) but this showing payment for services rendered. At the time, I had not yet made payment.
My dentist told me to wait until they send it in again. So therefore no out of pocket payment was made. I can not send in bills to FOC unless I make a payment after insurance has been applied. Since I did not want to miss the year window again, I sent in a proof of payment when no such had been made.
I sent this along with my EOB showing partial coverage and my ex's showing no coverage. At the time, I did have a balance owing on my account.
After this was submitted to FOC, my ex's insurance (now the correct one being billed after 7 mths) ended up denying additional coverage. The dental office wrote off the uninsured amount. I had no out of pocket expenses. Because my ex's EOB's finally went to the FOC his amount due was removed from his medical file. He paid no out of pocket expenses.
Because I sent in a statement showing I paid when I did not, is this a fraudulent claim to FOC or insurance co?
What are the consequences I could face?
Any advice on how I could handle this as I was not intentionally trying to get any money that was not due to me?
My ex knows no money has been paid by me or himself and the FOC has credited him. As far as FOC is concerned, it's over. My ex is pursing this issue as a insurance fraud claim. How he will do that I am not quite sure. I just would like to be prepared for the worse.
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