Question about reimbursement

[wukie2001]

What is the name of your state? What is the name of your state? CA

If a person went to see a doctor, who was covered by medical insurance, but didn't have the insurance card at the time of visit, and had to pay non-insurance rates of the hospital, could the person ask the insurance company to reimburse the difference they had to pay?

I ask this because the custodial parent of my child is claiming that I must pay 1/2 of the medical expenses she incurred like I described above. Granted, I am court ordered to pay 1/2 of medical expenses not covered by her insurance, but this doesn't seem right to me.

She took our child to the doctors and said she had to pay "non-insurance rates" and I can just sense that she will be sending me a bill this month. I want to know if I can tell her to contact the insurance company and ask them to reimburse her.

 

[cbg]

Yes, she can. She will have to provide them with a copy of the bill and proof of what she paid.

However, it's up to the insurance carrier and/or their contract with the provider as to whether they will pay her directly, or whether they will pay the hospital and have the hospital reimburse her. In some cases, their contract with the hospital says that they will make all payments directly; if that is the case, the insurer will pay the hospital and the hospital will reimburse her. So she may not get her money right away.

BTW, in many cases, a hospital or doctor can call a toll-free number and verify that an individual is covered regardless of whether they have their id card with them or not.