Egads more Ortho Problems

[penelope10]

What is the name of your state (only U.S. law)?Tx
Hi Gang,

Any suggestions on where I go from here would be welcome. Oz has now taken Lil Bit to an Ortho of his choice. I am willing to go with this Ortho, however, OZ is now stating that this Ortho doesn't think treatment needs to be started for 6 months....I called the Ortho and found out this is not true. Braces could be held off for around 4 months until her twelve year molars come in (she's 14 and a late bloomer), but a spacer needs to be put in to keep her teeth from shifting more. Plus there will have to be some oral surgery done by another dentist to remove a tooth that is growing in sideways, and to pull another tooth down into place. I have gone the extra mile and taken out dental insurance through my new job that would pay up to $1500.00 of Ortho. (The decree states he is to carry all dental and health for her). His dental does not cover Ortho.

Previously OZ agreed to pay his half up front. After going round and round for months, he finally gave me a check for his half of the charges from the originally agreed to Ortho in October. (Rather than making the check out to the Ortho as requested, he made the check out to me) Almost immediately after giving me the check, he called and stated he wanted to check out another Ortho. It took almost a month to get an appointment with this Ortho---the appointment was yesterday. I have held on to his check and not cashed it until all this could be worked out...

Now Oz wants this Ortho to subtract the $1500.00 my insurance will pay up front from the contract. The Ortho will not do this because my insurance will not pay the $1500.00 up front. Payment will be made as treatment is done and will be mailed to me. I am more than willing to give him his check back,let him cut a new check to the dentist for his now reduced half (about $400.00 less than what the original Ortho would have charged) plus give him 1/2 of any reimbursements the insurance company sends. (Payments will go to me and not the dentist).

He now wants to wait until at least after January.No explanation as to why, I'm pretty frustrated since this has been going on since June.

As I stated, any suggestions as to speed up this process or anything else I can do would be greatly appreciated.

 

[LdiJ]

What is the name of your state (only U.S. law)?Tx
Hi Gang,

Any suggestions on where I go from here would be welcome. Oz has now taken Lil Bit to an Ortho of his choice. I am willing to go with this Ortho, however, OZ is now stating that this Ortho doesn't think treatment needs to be started for 6 months....I called the Ortho and found out this is not true. Braces could be held off for around 4 months until her twelve year molars come in (she's 14 and a late bloomer), but a spacer needs to be put in to keep her teeth from shifting more. Plus there will have to be some oral surgery done by another dentist to remove a tooth that is growing in sideways, and to pull another tooth down into place. I have gone the extra mile and taken out dental insurance through my new job that would pay up to $1500.00 of Ortho. (The decree states he is to carry all dental and health for her). His dental does not cover Ortho.

Previously OZ agreed to pay his half up front. After going round and round for months, he finally gave me a check for his half of the charges from the originally agreed to Ortho in October. (Rather than making the check out to the Ortho as requested, he made the check out to me) Almost immediately after giving me the check, he called and stated he wanted to check out another Ortho. It took almost a month to get an appointment with this Ortho---the appointment was yesterday. I have held on to his check and not cashed it until all this could be worked out...

Now Oz wants this Ortho to subtract the $1500.00 my insurance will pay up front from the contract. The Ortho will not do this because my insurance will not pay the $1500.00 up front. Payment will be made as treatment is done and will be mailed to me. I am more than willing to give him his check back,let him cut a new check to the dentist for his now reduced half (about $400.00 less than what the original Ortho would have charged) plus give him 1/2 of any reimbursements the insurance company sends. (Payments will go to me and not the dentist).

He now wants to wait until at least after January.No explanation as to why, I'm pretty frustrated since this has been going on since June.

As I stated, any suggestions as to speed up this process or anything else I can do would be greatly appreciated.

Yes, I have an idea. I would cash the check, get things started with the ortho that he prefers, and refund dad any excess.

 

[Humusluvr]

Seriously, cash his check. Why do you have to take on the expense of dental through your job when he is decreed to do it? Its his "fault" this is not being taken care of.

Contempt contempt contempt. lawyers fees.

 

[qurice]

Seriously, cash his check. Why do you have to take on the expense of dental through your job when he is decreed to do it? Its his "fault" this is not being taken care of.

Contempt contempt contempt. lawyers fees.

I disagree. Go back and read her previous posts. Dad IS currently providing dental insurance, but it doesn't cover ortho expenses.

However, it is his fault that the work is not starting when it should.

Perhaps he wants to wait until January because he's switching dental plans?

 

[Humusluvr]

I disagree. Go back and read her previous posts. Dad IS currently providing dental insurance, but it doesn't cover ortho expenses.

However, it is his fault that the work is not starting when it should.

Perhaps he wants to wait until January because he's switching dental plans?

I am aware that dad is providing insurance. He SWITCHED plans to one that does not cover the ortho. He basically changed to an insurance coverage that is lacking.

She should cash the check.

I was thinking he might be waiting to add up expenses for a calendar year and try to deduct it, or meet his deductible.

Or, he's just being a jerk-off. That is my vote.

 

[LdiJ]

I am aware that dad is providing insurance. He SWITCHED plans to one that does not cover the ortho. He basically changed to an insurance coverage that is lacking.

She should cash the check.

I was thinking he might be waiting to add up expenses for a calendar year and try to deduct it, or meet his deductible.

Or, he's just being a jerk-off. That is my vote.

I suspect its something along those lines as well.

 

[Humusluvr]

I suspect its something along those lines as well.

Which one? Jerk-o or deductible? Or both???

 

[qurice]

I am aware that dad is providing insurance. He SWITCHED plans to one that does not cover the ortho. He basically changed to an insurance coverage that is lacking.

While that is true, he still technically is providing coverage. Mom was informed when the change happened, she just wasn't made aware of the coverage changes. Crappy coverage, but still coverage.

She should cash the check.

I do agree with that.

I was thinking he might be waiting to add up expenses for a calendar year and try to deduct it, or meet his deductible.

Maybe trying to avoid paying a 2008 deductible knowing treatment will run into next year and have to pay the deductible again in two months.

Or, he's just being a jerk-off. That is my vote.

It could be that too

 

[penelope10]

Thanks all. I'll think about cashing the check. I hesitated because I didn't want to be accused of doing something underhanded---the check is made out for a larger amount than what his half would be with the new Ortho. (Not taking into account my dental insurance). Of course, I would cut him a check for anything owed back to him immediately.

Lil Bit has had only routine office visits so she hasn't maxed out her amount of coverage for 2008 on his policy. Plus there is no deductible.. He will be changing plans again in January, however, that plan will not cover Orthodontics. I talked to his HR person. The firm has decided to go with another company that WILL NOT offer ortho in 2009.

Without going into too many details I think OZ is tapped out and has started living way beyond his means. I believe he's hoping that he will get a partnership distribution check in December and that's why he wishes to wait until January. Before I got the check for Ortho that I'm holding, he told me he was trying to get money that the firm "owed" him. (Then a short time later he gave me the check) I suspect that the firm is not doing as well as it once was based on the industry it practices in---he makes plenty of money without the distribution...however when he goes on two week vacations to Europe etc, etc, he does need the distribution to survive. I imagine the other partners probably chose to reinvest their distribution back into the firm---so I'm guessing that they may not be too happy with him right now. So the guy may end up being bought out by the partners, or the firm may choose to dissolve the partnership eventually. I can see the other two partners starting a whole new partnership without OZ....These two other guys live pretty conservative lives and I can't see them being too patient if they reinvest their share back into the firm to avoid layoffs etc. and Oz chooses to to otherwise.

Sorry to sound like "sour grapes"--it just ticks me off when he makes it so dang hard to get something done that Lil Bit needs. He told me that the new Ortho told him Lil Bit could wait 6 months before treatment was started at all. I called the Ortho and was told that this is NOT true. She needs to get a spacer put in immediately to avoid any additional shifting to the teeth, dental surgery a little later on, and some additional treatments**************I sent a polite email to him with the correct information from the Ortho. Then Oz suggested January---I then sent him an email asking him why wait till January? His reply, "What Ortho do you want to go with?" No mention of the cost split or anything else......UGH!

Thanks again for the suggestion about cashing the check. I may end up having to do this. I'm just trying to avoid a full blown knock down drag out.

 

[Zephyr]

Penelope, in your shoes, I would deposit dad's check, and do as you indicated, cut him a check immediately for any refundable amount...I would also talk with him about you (if you could afford it) paying the expenses for the spacer and whatnot...the stuff that must be done before the braces can get put on anyway...so that way if he is waiting for the new policy or the new year fine...you guys can even out who spent what when it comes to the braces.....this is of course- IF you can afford it and IF you guys get along well enough to work this out together