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Yet Another Medical Bill

CastleJJ's picture

We mailed BM a check for $100 for SS' ENT office visit and she informed us today that she received and cashed it. She then responds again, stating that she is sending DH two more medical bills for SS... Like what is going on?! We have paid hundreds of dollars in the past few months in out-of-pocket medical expenses and we haven't even gotten the huge bill for SS' throat scope yet. When is enough going to be enough? 

It appears that SS has been receiving OT services for 6 months. That is a huge amount of time to receive therapy for what BM said was "sensory processing disorder" related to ADHD. SS said all they do at OT is stretches. What is 6 months of treatment going to do for that? Especially when SS is playing loads of sports!

Does anyone know if you can stop paying out-of-pocket? Is there an annual limit as far as how much BM can request for reimbursement? I just hate that DH has no say in medical decisions, having to accept every decision BM makes, only to get stuck with 42% of every bill. We are literally getting medical bills from BM every 1 to 2 weeks. 

Comments

advice.only2's picture

You guys just bought a new house and had a baby...shocker she's suddenly getting married and all these medical bills.  She's doing whatever she can to keep herself relevant to DH and nickle and dime him at the same time. 

CompletelyPuzzled's picture

My daughter has sensory processing disorder.  It's a real thing so not sure why you put it in quotation marks.  It is often seen in kids with autism or ADHD.  She has been in therapy for almost 8 months and we are just now seeing results.  It is often a long term therapy.  I doubt BM is just loading up on medical bills when she is paying over half.

 

If the cost is too much, then you could see about a different therapist.  In my experience working in insurance, co-pays for therapy aren't usually really high unless you have a high deductible insurance.  You may want to request EOBs to make sure you are being charged for just the out of pocket expenses.

CastleJJ's picture

Hi CompletelyPuzzled - I am not stating that sensory processing disorder is not a legitimate condition. My brother is on the autism spectrum and also had a sensory processing disorder which required OT for years. He could not tolerate textures in foods. I just do not believe the validity of SS' conditions. 5 years ago, BM told DH that SS was diagnosed with ADHD - yet she refused to provide any documentation of the diagnosis and the documentation from the doctor's notes never mentioned it either. BM used this as her justification for why SS was rejected from the gifted and talented program at school. The teachers have never expressed SS experiencing any ADHD symptoms and we have never heard about it again. Then, the week my DD is born, BM emails stating that SS developed a sensory processing disorder almost overnight and that he is receiving OT services for it. Again, she refused to provide medical documentation or a medical bill - just payment confirmations. This OT center also provides pay-to-use open gym that you can do (not formal OT services) and SS mentioned doing that to make himself more agile for sports - which is BM's whole focus. She wants SS to be the next NFL player. I wouldn't question the validity of anything if BM wasn't so high conflict.

We have finally received the bills for $169 for every two visits of OT that outline services provided. We pay half of it. We cannot request a different therapist as BM has sole custody and sole medical decision making. 

dragonfly878's picture

Now that you have a baby and a house- request a modification to CS. Each state is different but once DH and I had DD and bought a house- his CS cut in half. You have to be able to provide for both kids equally and they will factor your daughter into the equation.

I would also keep receipts of medical expenses, too. Explaining the situation that you're handcuffed by her medical decisions that she alone makes. 

CastleJJ's picture

I'm concerned about asking for a child support review. Our state only factors income, overnights, and other dependents. They don't look at living expenses like a mortgage. DH makes about $5k more than he did at the time of last review, but he also works a crap ton of overtime to overcompensate for the loss of wages due to CS, so I worry that his CS would go up. BM is likely making more, and I also know she is doing private therapy as well, so maybe it would go down. I just dread the idea of it going up. 

We keep every single reimbursement request BM sends, along with the bill and the check deposit from our bank showing it was paid and BM cashed it. Our bank even uploads the photo of the signed check with BM's signature, so we print all of those off in case she ever disputed not receiving payment.  

CastleJJ's picture

WOW! I just looked at our county's FOC site to determine if a CS review could be conducted. It states that requests for modification will be denied in two situations if the only change in circumstance is: 1) if the person filing has a change in family size (marriage, adoption or birth) CHECK FOR US or 2) If the custodial parent's income has increased. CHECK FOR US. So essentially, our motion would be denied because these are the only two factors we could base our request on. 

So we filed a request for modification, it would be denied because the only change in circumstance is the birth of DD and BM making more money. But if DH makes more money, BM can file. Oh and if DH is laid off (like he was during COVID lockdown and the company told him they wouldn't bring him back) his wages were imputed. I frickin hate the FOC and their processes. 

CastleJJ's picture

I guess not. According to the document, our county's court highlights that additional children should not be conceived if they cannot be provided for within the financial budgets of their parents. They will not reduce support to support additional children. 

thinkthrice's picture

That's like our state.   The 2nd family is persona non grata.

strugglingSM's picture

I hope they publicize that to everyone - "be very careful about who you have your first child with...they will always get more from you than any subsequent children." 
 

BM and MIL try to act like SSs are entitled to more somehow...as if DD doesn't have just as much of a right to exist as a person. The irony is that DH's surprise / mistake baby sister gets far more than he does from MIL, but unfortunately, her reasoning does not apply to our situation. 

CastleJJ's picture

Right! SS was conceived between BM and DH when they were 19 and BM was in a bad headspace and wanted a baby to make her feel better emotionally. She tampered with the birth control to get pregnant. DH will pay 18 years for sleeping with a crazy person as a teenager. 

Yet to have DD, DH and I had to financially plan and save for years, just to consider starting a family, after 9 years of being together. We had to make sure our budget was adequate to support DD after CS payments because we doubted it would go down because we had a baby together.

So because BM was the "first," she is the priority, even though they were dumb teenagers. Yet to the courts, I am the idiot and irresponsible one for marrying DH and adding another baby to the mix, creating the unnecessary "second family" that DH couldn't afford. 

dragonfly878's picture

You also bought a house- so your financial landscape may change due to that, too.
 

You don't just have one reason you have multiple (at the very least, two), expanded family AND BM's income increase. They stated it would be denied if the "only" reason was X or Y. You have both X, Y, and even more.
 

Also isn't BM getting married? Will try try to factor your and BM's wife's income into the equation? 

Seems odd that after expanding your family, buying a house, BM getting married and BM's income increase that they wouldn't make a change. You simply can't pay what you don't have so how do they expect him to continue to pay? They probably say not to expand the family as a threat.... yes, you and DH can afford your daughter. However your daughter has the same rights as his son. Perhaps he can no longer afford to pay for his son in the same way? idk it doesn't sound like you have much to lose. CS on top of medical bills? You and your DH seem to be getting screwed with this whole setup. 

CastleJJ's picture

No, the document said they would deny the case based on any of the following: x, y, z. Based on that, it appears we do not have grounds to file a request for modification. The house is irrelevant - the courts say that everyone has living expenses so they do not factor those expenses when calculating CS. 

In our state, the courts refuse to add stepparent income into consideration. BM could marry a millionaire and they would not take their income into account because they aren't responsible to provide for skids.

We likely are getting screwed by the situation, but our country really doesn't care. This is the same county that wouldn't grant DH more than 6 weeks of visitation per year, based on the grounds that "a child needs their Mother." At one point, after $750 CS was deducted, DH's take home pay was $1800 per month. He asked the judge how he was supposed to live on that. The judge responded, gets two or three jobs if you have to or have your wife pay more of the household bills." The CS system is a joke. 

dragonfly878's picture

That's wild.... "have your wife pay more of the household bills." So yes, while indirect, they do factor you into the equation if they would have DH rely on your income to pay household bills.

IDK something seems odd here. Did they give examples of when your DH could file for modification? 

CastleJJ's picture

The document stated the a modification can be filed only if the non-custodial parent had a significant increase or decrease in income or if the NCP lost their job. 

ndc's picture

In my state the NCP pays solely based on the NCP's income.  For two kids it's 25% of gross income.  It doesn't matter if the CP is making many multiples of what the NCP makes or if the NCP has another family.  CP's income isn't taken into account and there are no deductions for NCP based on other expenses.  

thinkthrice's picture

In NYS.  They want to know every.scrap.of.income at the NCP's household, but the CP (99% of the time the BM) can marry Jeff Bezos and they wouldn't count the stepDAD's income.   

In THEORY they don't count NCP SM's income but really they do in the way her income frees up NCP bioDAD from any household expenses he WOULD incur, thus freeing up EVEN MORE CS to the CP BM.

Chef at one point was paying $370 a week (making $15-20 an hour at most)  after sky high NYS taxes and health insurance, he would often net $100 a week.  The court doesn't care that NCP biodad has nothing to live on.   The self support reserve is a joke and is less than someone on welfare would get not including EBT, utility/housing subsidies, etc.

Thumper's picture

Have you seen any bills----NOT what bm sends but real bills a medical office sent? I WOULD find a way to have bills sent to dh. Do not ask bm for them. Too many bm's have learned to cut and past documents.

Next, doesnt dh court order reflect unreimbursed medical?

It might be time to talk to a lawyer about modification specifically for medical, out of pocket. BUT first get a hand on the bills.

 

CastleJJ's picture

Yes, the bills we receive match what the medical office provided. DH's CO states that he will pay 42% of all out-of-pocket medical expenses after BM meets her annual minimum ($400). There is not dollar amount limit set to how much she can request reimbursement for in a year. 

We aren't talking to an attorney. In our county, BM is always favored, so we are not going to seek any sort of modification. We went to court in 2019 and after a year of a traumatic custody battle, $30k in legal fees, and absolutely no change, we gave up. The only "change" that occurred as a result of that battle was DH's CS went up.

simifan's picture

Have you gotten the EOBs or a denial of service letter? If SS had this SPD & OT is needed then insurance should cover the sessions & you should only be paying the co-pay. When I had to submit for reimbursement, I got the full bills from my PT office. I had to submit them with documentation of injury diagnosis to be reimbursed. 

CastleJJ's picture

We don't receive EOBs. There haven't been any denials. We receive the bills that the OT office sends, showing insurances payment and the remaining outstanding balance. We pay 42% of that balance. But, because it appears that BM has terrible insurance, the out-of-pocket balance for two visits is $169. 

Now DD is going to PT every week - our copay is $40 per visit. Everything else is picked up by insurance. But I know, I have really good insurance coverage. I just think BM has crap insurance which is why it is so costly.