unnecessary medical claims

[medicalbillhelp]

What is the name of your state? New York

I am responsible for providing medical insurance for my two children. I have joint custody but their primary residence is with their mother. I am responsible for all medical, dental, etc. that is not covered by my medical insurance plan.

I have always provided the best medical insurance available but their mother fails to use the plan to her benefit. She is constantly sending me bills from doctors who are not within my coverage network or who do not have the proper certifications to be recognized. I have been urging her to find doctors who are part of my insurance network.

Question: am I responsible for paying her for bills she incurs just because she doesn't take the time to find the right doctors? She also tells me I am responsible for filling out the claim forms - but she doesn't give me all the information to make a claim. By the time I get the bills from her there is a whole pile of research to do to fill out a claim - the stuff is never organized and it is very time consuming to figure it all out. She usually sends a stack of bills every 4 months or so...and she wants me to reimburse her immediately & then figure out how to get everything submitted on my own.

If she would only use the insurance plan and all of the benefits we could avoid this whole mess and she would never have to advance anything more than a $20 copay. Can I force her to do that.

the wording in my divorce agreement is as follows:
------------------

The parties agree to utilize those health care providers who participate in the medical insurance plan provided by the Father. In the event that either child is in need of medical attention, and a party shall fail to utilize such plan, then such party shall be liable for any unreimbursed amount, except in the case of emergency treatment.
The Mother agrees that she will promptly fill out, execute and deliver to the Father all forms and provide all information in connection with any application the Father may make for reimbursement of medical, dental and drug expenses under any insurance policies which he may have. If either party shall have advanced moneys for said expenses which are covered by insurance and for which a recovery is made for insurance claims filed for said expenses, the payment by the insurance carrier shall belong to the party so advancing said moneys and any checks or drafts or proceeds thereof from the insurance carrier shall be promptly turned over to the party so advancing said moneys.

 

[haiku]

per the court order she is in contempt, and owes you for taking the child out of network. You also need to enforce the court order regarding the forms.

This is a simple process if you have all the paperwork to back up your contempt claim.

 

[LdiJ]

What is the name of your state? New York

I am responsible for providing medical insurance for my two children. I have joint custody but their primary residence is with their mother. I am responsible for all medical, dental, etc. that is not covered by my medical insurance plan.

I have always provided the best medical insurance available but their mother fails to use the plan to her benefit. She is constantly sending me bills from doctors who are not within my coverage network or who do not have the proper certifications to be recognized. I have been urging her to find doctors who are part of my insurance network.

Question: am I responsible for paying her for bills she incurs just because she doesn't take the time to find the right doctors? She also tells me I am responsible for filling out the claim forms - but she doesn't give me all the information to make a claim. By the time I get the bills from her there is a whole pile of research to do to fill out a claim - the stuff is never organized and it is very time consuming to figure it all out. She usually sends a stack of bills every 4 months or so...and she wants me to reimburse her immediately & then figure out how to get everything submitted on my own.

If she would only use the insurance plan and all of the benefits we could avoid this whole mess and she would never have to advance anything more than a $20 copay. Can I force her to do that.

the wording in my divorce agreement is as follows:
------------------

The parties agree to utilize those health care providers who participate in the medical insurance plan provided by the Father. In the event that either child is in need of medical attention, and a party shall fail to utilize such plan, then such party shall be liable for any unreimbursed amount, except in the case of emergency treatment.
The Mother agrees that she will promptly fill out, execute and deliver to the Father all forms and provide all information in connection with any application the Father may make for reimbursement of medical, dental and drug expenses under any insurance policies which he may have. If either party shall have advanced moneys for said expenses which are covered by insurance and for which a recovery is made for insurance claims filed for said expenses, the payment by the insurance carrier shall belong to the party so advancing said moneys and any checks or drafts or proceeds thereof from the insurance carrier shall be promptly turned over to the party so advancing said moneys.

Have you provided mom with an insurance card? That is generally a major step to avoid complications.

Making sure that you provide mom a full list of providers is important too. If you can't demonstrate that you have provided mom both a card and a list you could be held liable.

 

[eyemback]

Have you provided mom with an insurance card? That is generally a major step to avoid complications.

Making sure that you provide mom a full list of providers is important too. If you can't demonstrate that you have provided mom both a card and a list you could be held liable.

Let's not spin this...The language in the order is pretty cut-n-dry. She's in contempt. She's also abusing the coverage and intentionally burdening the father with excessive costs. I am sure a list of providers is not an issue. Not to mention, this is easily accessible via the internet from the providers.

OP...does your order specify anything about out-of-network providers? You should be filing contempt paperwork against your ex, in addition to her abusing the coverage and creating excessive costs onto you. You have the proof.

In the meantime, I suggest calling your insurance company to put a block on on out-of-network providers. I did.

 

[LdiJ]

Let's not spin this...The language in the order is pretty cut-n-dry. She's in contempt. She's also abusing the coverage and intentionally burdening the father with excessive costs. I am sure a list of providers is not an issue. Not to mention, this is easily accessible via the internet from the providers.

OP...does your order specify anything about out-of-network providers? You should be filing contempt paperwork against your ex, in addition to her abusing the coverage and creating excessive costs onto you. You have the proof.

In the meantime, I suggest calling your insurance company to put a block on on out-of-network providers. I did.

How in the heck is she in contempt? The issue isn't whether or not she is in contempt (because she isn't) the question is whether or not he is liable for the costs for out of network care.