Health Costs

[Xrandy]

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

Background- I, the NCP, reside in California. CP and I were divorced in Missouri in 2003. CP and my son (16 years old) now live in Tenn. I provide health care, as directed by the divorce decree, for my son.

CP took him to have a routine procedure done (ear wax cleaned out of his ears) to a medical provider that did not use my health insurance. CP told the med provider to send the bill to me.

Am I required to pay this? Is the CP not required to at least make a good faith effort to find a provider that is in my provider network?

Thank you in advance for any advice.

 

[haiku]

how exactly does your agreement spell out healthcare cost and out of network cost?

 

[LdiJ]

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

Background- I, the NCP, reside in California. CP and I were divorced in Missouri in 2003. CP and my son (16 years old) now live in Tenn. I provide health care, as directed by the divorce decree, for my son.

CP took him to have a routine procedure done (ear wax cleaned out of his ears) to a medical provider that did not use my health insurance. CP told the med provider to send the bill to me.

Am I required to pay this? Is the CP not required to at least make a good faith effort to find a provider that is in my provider network?

Thank you in advance for any advice.

Its probable that it was not reasonable for mom to have the doctor send the bill to you, but its not guaranteed.

Cleaning out earwax is not necessarily "routine". I am a perfect example of that. I have crooked ear canals and if I have an earwax problem I flat out cannot hear. In fact, when I was a child it got me labeled a few times as having hearing problems..LOL, when all it was, was earwax. For years, for me, that meant an immediate visit to wherever I could get in. Since then, I have, by trial and error, discovered ways to deal with it by myself, without hurting my eardrums, but it took years to figure it out.

Now...after explaining that...are there a reasonable amount of providers in TN that accept your insurance?...within a reasonable geographic distance from mom? Could mom have reasonably found a provider that accepted your insurance in a timely manner?

Has this been an ongoing problem that there are few, or no providers in mom's area that accept your insurance?

If its an ongoing problem then what you really need to do is take it back to court to get alternate arrangements made for your child's insurance. Sometimes it can even be more cost effective to provide private insurance for a child when employer insurance makes things too restrictive between states (and sometimes its even less expensive).

However, if mom has plenty of providers to choose from within a reasonable geographic distance, then you need to refute the doctor billing you since you didn't sign anything.

 

[Xrandy]

Haiku,

The decree states that I am to provide medical and dental insurance, and that I am to pay for what is not covered by insurance. I understand that I would have to pay if my son needed treatment that was not covered by my insurance. But does this mean that my ex can just frivoulously take my son to whatever provider she wants without at least trying to find a provider in my network?

LdiJ,

Thanks for your input. I understand that the procedure could be serious with complications, and I did not mean to make light of it.

Yes there are many providers in CP's area. She didn't check out providers and didn't even take him to the general practioner, she just went to a clinic near her. She made no effort what-so-ever to find one (beleive me if she were fitting the bill she would have made sure she found a network-provider).

 

[LdiJ]

Haiku,

The decree states that I am to provide medical and dental insurance, and that I am to pay for what is not covered by insurance. I understand that I would have to pay if my son needed treatment that was not covered by my insurance. But does this mean that my ex can just frivoulously take my son to whatever provider she wants without at least trying to find a provider in my network?

LdiJ,

Thanks for your input. I understand that the procedure could be serious with complications, and I did not mean to make light of it.

Yes there are many providers in CP's area. She didn't check out providers and didn't even take him to the general practioner, she just went to a clinic near her. She made no effort what-so-ever to find one (beleive me if she were fitting the bill she would have made sure she found a network-provider).[/QUOTE]

If mom was being blatantly lazy about it, then dispute the bill if you feel that mom was out of line.

However, if it was the case that your son suddenly couldn't hear, and mom needed to get it resolved before school the next day, an after hours clinic may have been the only viable option.

You may want to get the orders changed so that mom is responsible for 1/2 of the bill, that might make her think twice before doing something like that.

However, if your son is 16, you don't have that much more time to be responsible...make sure that the cost doesn't outweigh the gain.