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Court ordered Medical Reimbursement

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LdiJ

Senior Member
When my child was on state insurance I have gotten bills before the state insurance as secondary picked up and after the primary insurance paid. And the amounts were not necessarily trivial. When my daughter had tubes put in her ears there was the deductible of $500 that was not covered as well the 20% that insurance didn't cover after the deductible was met. It amounted to about $650. Now couple that with the $20 copays and such, mom could be making a nice profit. Hence why bills are required.
And LD the spreadsheet will NOT work in court -- which is where mom would want to take this when dad refuses to pay. I have had people (opponents) try to submit spreadsheets rather than actual bills or checks proving payment and after a simple objection from me, the judge has not allowed them but has wanted the "best evidence" available.
You misundertood me. I didn't say that the spreadsheet alone would work. I said that the spreadsheet backed up by the bills would work, particularly if the spreadsheet assigned mom's proper responsibility for her portion of the bills to her.

I don't think that mom necessarily has a problem providing the dad with the basic bills. Her emphasis seems to me to be on the fact that its none of dad's business how she pays her share.
 


Thanks everybody! Didn't know I was trying to beat my ex out of his money. At any rate, I have Blue Cross Blue Shield for medical coverage, which costs me $264.50 for child alone due to her epilepsy. I've already met my $250 deductible for her medications and doctors visits. CS started March 1, and on April 3, the deducible was met.

The spread sheet has all medications and doctor/dentist visits detailed. I have EOB's, receipts for meds, etc. I just prefer not to give him copies of my checks. Sorry. If he has that information, then he can have his mother, sister, wife, etc., call the bank for account info. Heck, anyone can use the routing number and checking account number to make payment over the phone to the electric co, phone co, pay bills online. I'd just prefer to keep my money--my money.

Believe me, I don't want a dime from him that isn't due me. As for giving him bill info, I will send a copy of the items by certified mail on the last day of each month, and give him til the first of the next month to pay. He should be able to avoid buying a new video game or dirty magazine to help keep his daughter healthy.

And yes, this is the same jerk that wrote the CS check payable to the daughter.
 
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Is it possible to black out the info you don't want him to have (your bank account and routing number/ Credit card number/ etc). Then he has proof you actually paid, but doesn't have access to your info.
 

ceara19

Senior Member
Thanks everybody! Didn't know I was trying to beat my ex out of his money. At any rate, I have Blue Cross Blue Shield for medical coverage, which costs me $264.50 for child alone due to her epilepsy. I've already met my $250 deductible for her medications and doctors visits. CS started March 1, and on April 3, the deducible was met.

The spread sheet has all medications and doctor/dentist visits detailed. I have EOB's, receipts for meds, etc. I just prefer not to give him copies of my checks. Sorry. If he has that information, then he can have his mother, sister, wife, etc., call the bank for account info. Heck, anyone can use the routing number and checking account number to make payment over the phone to the electric co, phone co, pay bills online. I'd just prefer to keep my money--my money.

Believe me, I don't want a dime from him that isn't due me. As for giving him bill info, I will send a copy of the items by certified mail on the last day of each month, and give him til the first of the next month to pay. He should be able to avoid buying a new video game or dirty magazine to help keep his daughter healthy.

And yes, this is the same jerk that wrote the CS check payable to the daughter.
This is the first mention you have made about showing him a check. Your question was:
My question is do I have to provide him receipts and info from the insurance company?
The answer to THAT question remains the same. If you want reimbursement, you HAVE to provide these things to him. What dad did with the child support check was very wrong, but that is no excuse for you to play tit for tat. It would only end up backfiring on you in court.
 
I could be 100% perfect and still get screwed in court. I just didn't know if he needed copies of the eob's, etc.. Whatever info I give him, I will definitely mark out the account numbers and all.

I don't want to play games like he does. But I do get really tired of towing the line, and he does whatever he wants and is never held accountable in court--even though things are brought to the judge's attention.
 

ceara19

Senior Member
Actually, a spreadsheet COULD work.

If the spreadsheet listed all of the bills, and the amount that can be proven was paid for by insurance, and then listed the remainder due (bill by bill), and she only asked for reimbursement of the remainder due in excess of 250.00, and only his percentage share, it really might fly....as long as she had the actual bills and eobs available as backup.

That eliminates her problem of not wanting to disclose how she pays the bills....because she would be asking for reimbursement of only those in excess of what she is responsible to pay.

Its a basic accounting concept. It really shouldn't matter if she has actually paid, or how she paid, what she is responsible to pay, only that she is not asking for dad to pay anything more than what he is responsible to pay.
There's no "back up" to it. The bills will HAVE to be given to dad before he is legally obligated to pay. Since the bills MUST be submitted, making an extensive spreadsheet for the purpose of reimbursement is just a complete and utter waste of time.
 
There's no "back up" to it. The bills will HAVE to be given to dad before he is legally obligated to pay. Since the bills MUST be submitted, making an extensive spreadsheet for the purpose of reimbursement is just a complete and utter waste of time.
Agreed, I certainly would not reimburse anyone from a spreadsheet created by them. However, would not the EOBs be sufficient legally for the ex to determine his 62% of out-of-pocket? Maybe the OP's are different, but my EOBs reflect what the total bill was, what insurance covered, and what the patient's payment is. It does not have any information about how I paid, if or when I paid, or my check or credit card information. Only the doctor's office has that.

Does your court order specify that you have to prove full payment of the bill BEFORE he pays his 62%? If you give him each EOB upon receipt, he should be able to determine when the deductible is met and how much his share of costs are. Giving him copies of checks and/or credit card receipts seems unnecessary. Why make it harder than it has to be?

Am I missing something?
 

seniorjudge

Senior Member
There's no "back up" to it. The bills will HAVE to be given to dad before he is legally obligated to pay. Since the bills MUST be submitted, making an extensive spreadsheet for the purpose of reimbursement is just a complete and utter waste of time.
No kidding.

Somehow, people think if they a nifty looking spreadsheet (in ANY kind of lawsuit) that it is evidence!
 

MrsK

Senior Member
I could be 100% perfect and still get screwed in court. I just didn't know if he needed copies of the eob's, etc.. Whatever info I give him, I will definitely mark out the account numbers and all.

I don't want to play games like he does. But I do get really tired of towing the line, and he does whatever he wants and is never held accountable in court--even though things are brought to the judge's attention.
All you have to give him is the BILL. Nothing having to do with your checks or payment info. A copy of the BILL.

Why is that so hard?

If you are paying 100% and he is reimbursing you, call the Dr's office, ask for a new copy of the bill showing its been paid, and send him that. So simple.
 

Ohiogal

Queen Bee
Agreed, I certainly would not reimburse anyone from a spreadsheet created by them. However, would not the EOBs be sufficient legally for the ex to determine his 62% of out-of-pocket? Maybe the OP's are different, but my EOBs reflect what the total bill was, what insurance covered, and what the patient's payment is. It does not have any information about how I paid, if or when I paid, or my check or credit card information. Only the doctor's office has that.

Does your court order specify that you have to prove full payment of the bill BEFORE he pays his 62%? If you give him each EOB upon receipt, he should be able to determine when the deductible is met and how much his share of costs are. Giving him copies of checks and/or credit card receipts seems unnecessary. Why make it harder than it has to be?

Am I missing something?
No the EOBs are NOT sufficient legally because they only show what ONE insurance paid and not if there are other insurances that cover the child. That is why the bill is so important. The bill would show what insurance companies are being billed, how much the appointments/treatments were, any co-pays and insurance reimbursements, as well as any other payments that have been made.
 
OG - True, a second insurance could well pick-up the out-of-pocket expenses of the first. But, as MrsK points out a copy of the bill can be provided w/o the OP's personal check or credit information. It still seems the OP is making this harder than it needs to be.

Must admit I'm not familiar with what information is on the doctor's bill, it all goes straight to my insurance company.
 

MrsK

Senior Member
OG - True, a second insurance could well pick-up the out-of-pocket expenses of the first. But, as MrsK points out a copy of the bill can be provided w/o the OP's personal check or credit information. It still seems the OP is making this harder than it needs to be.

Must admit I'm not familiar with what information is on the doctor's bill, it all goes straight to my insurance company.
That's because she IS making it much harder than it needs to be.

Dr offices send claims to the insurance company, they pay, Dr sends bill of remaining balance. Mom pays her portion and requests a new bill showing its paid to send to dad, asking to make sure its void of any personal info (although honestly, I've never received a copy of a paid bill with my info all over it, like they copy my check and attach it to the bill....NEVER happened)

This is so incredibly simple, I dont know why the OP thinks this is some big deal :rolleyes:
 

Ohiogal

Queen Bee
OG - True, a second insurance could well pick-up the out-of-pocket expenses of the first. But, as MrsK points out a copy of the bill can be provided w/o the OP's personal check or credit information. It still seems the OP is making this harder than it needs to be.

Must admit I'm not familiar with what information is on the doctor's bill, it all goes straight to my insurance company.
It could also be provided as just a bill once mom satisfies the fact that she has met her full portion of the yearly amount (such as the first $250 or whatever). Once mom proves to dad that she has paid that amount, she can just give him a copy of the doctor's bills before she pays anything and have him pay 62% of whatever the total is directly to the doctor and she pays 38% of the total directly to the doctor.

Mom is making this VERY difficult.
 

fairisfair

Senior Member
That's because she IS making it much harder than it needs to be.

Dr offices send claims to the insurance company, they pay, Dr sends bill of remaining balance. Mom pays her portion and requests a new bill showing its paid to send to dad, asking to make sure its void of any personal info (although honestly, I've never received a copy of a paid bill with my info all over it, like they copy my check and attach it to the bill....NEVER happened)

This is so incredibly simple, I dont know why the OP thinks this is some big deal :rolleyes:

doesn't work that way for me. My insurance pays a portion and my doctor requires that the rest of the charge be paid at the time of service. So I am constantly fightling with dad over what he needs to see in order to reimburse me for uncovered medical. He is of the opinion that the medical bill from the doctor is not enough, that he needs to see my method of payment. Guess he thinks the doctor fairy drops by and pays the bills and I am trying to scam him. Of course, he doesn't pay even when he has the copies of the cancelled checks.:rolleyes: Hence our friday date this week. We're double dating with the judge and his clerk. :D
 
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