Nice try BM2 - Medical Costs
BM2 just submitted her own homemade spreadsheet/bill for our 50% of medical costs. Earlier in the year, she took SS6 to see a psychologist since he kept getting in trouble for being the school bully. She couldn't be bothered to check if they were in network. It would have cost $20 for her to go in network. Instead she just picked one, which cost $130 per session, no insurance covered. She tried to submit that on the bill.
Unfortunately for her, I work in insurance, specifically medical malpractice. I know insurance like the back of my hand, and also have most of their decree memorized. The decree specifically states that both parents are ORDERED to use in-network providers (where available unless it is an emergency) and if they don't, that parent is responsible for 100% of the cost.
She tried to get us to pay this earlier in the year and DH pointed this out to her line and verse and she never responded. She tried to slip it on the bill. HA.
She also tried to add the Cord Blood Registry, which is $200 or something a year to store old blood from SS's umbilical cord in case of any future illness. This isn't even 100% that it can help. This is not medically necessary and was not agreed on, so that is on her as well.
Insurance is the place she is LEAST likely to screw us, considering my career (background as a former actuary and underwriter). All the kids are on my insurance from September on, so she better believe she is only allowed to follow the plan EXACTLY.
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Seriously. If you're going
Seriously. If you're going to try and trick us on anything, it shouldn't be banking or insurance (DH is in banking, me insurance). So stupid.
To have a BM that would
To have a BM that would actually pay 50% of medical. What a lovely dream. I am stuck Ina nightmare of a non paying BM....for ANYTHING
Ours is supposed to pay 23%.
Ours is supposed to pay 23%. When she had custody DH paid $500 a month in child support for ONE child and 71% of the medical bills. Somehow, BM gave up custody, pays a mere $124 a month in child support and still somehow pays even less of the medical bills than before. I don't know how that's possible.
Every time we give her paperwork for her portion we always wait the required 28 days then give the paperwork to the FOC who hassles and argues with us about it then begrudgingly sends BM a notice, waits 21 days, then tacks it on to her child support and she pays $50 a month towards the medical bills.
Of course, SD is SD and goes to therapy twice a week so there are constantly more bills being added and she just keeps getting farther behind but no one at the FOC seems to realize this. I wonder what the doctors would say if I said "I'm only going to pay $50 a month." Why do NCP's get away with so much crap?
In Michigan, the use a crazy
In Michigan, the use a crazy formula. They take the amount of money that each parent makes per month, Ansett together, and calls it available household income, or some stupid phrase like that.
Then, they assign each person's income is in a percentage of the total.
So, BM's monthly income is 23% of the total available money.
In our case, Medusa has to pay 21%, but never does. It's the BM dance, don't you know?
This is true. My husband has
This is true. My husband has been ordered to pay for things even when BM didn't follow the court order. We live in a very pro-BM province. She can get away with anything.
I have a feeling we live in
I have a feeling we live in the same province. BM can do whatever she wants
I have been WAITING for a
I have been WAITING for a medical insurance guru to post on the board! So here is our issue...
BM does not enforce that DH pay the 50/50 ordered for medical. She refuses to provide documentation, bills, receipts...she tried the paper hand written receipt and then just a snap shot of the $$ total, that did NOT fly so when we demanded the bill copy BM respectfully dropped the entire thing....she obviously wanted to score some cash but she also does not want us digging into the medical and possibly medical insurance side of things!
Bm is high conflict, we are limited email only communication. She is a terror and WILL NOT pass up a payday....then WHY would she not be enforcing this 50/50 medical payment? To me this seems like an easily enforced "you owe me this" drama game for BM to fight and carry on..
My wild theory...BM is doing what she does best, SHADY BUISNESS! I know she is on Aetna with the entire family because she once had to send us a photo of the card during a medical emergency (i literally mean had to twist her freaking arm off to send us one tiny/blurry photo of this insurance card)
Why is BM keeping the medical bills a secret? What could she be doing/hiding? She obviously does not want us involved enough to pass up $$! I don't understand how medical billing and insurance works or what secrets would need to be concealed...blows my mind!!!
Thanks!
You need to refuse any
You need to refuse any reimbursement until you receive an ITEMIZED bill from the provider. I have all of the kids on MY insurance, so I make the rules. I told them (and it is true) that they MUST provide an itemized bill for any care if they expect coverage from insurance and any money owed. Both BMs have a health spending card that I load money on, but it goes quick (SD15 is a type 1 diabetic).
I'm not sure why your BM would hide bills and NOT collect her due though. Very strange.
This is why I could never
This is why I could never have dealt with a BM and a minor child. I have a very logical, yes/no, black/white brain (worked in IT). Illogical crap like this makes my head explode.
People actually do that cord
People actually do that cord blood banking?? What a waste of money.
We do but are not going to be
We do but are not going to be paying for it going forward. If she wants it still, she can pay. I told her to donate the cord blood to a public registry if she doesn't want it. The odds of your child actually being able to use their cord blood are EXTREMELY low. Often times they can have more luck from a public FREE registry. For example, if your child got an illness, odds are it would be in their genetic makeup and already in the cord blood, rendering it useless. It could possibly help if they had a siblings cord blood, but again odds are astronomically low (again, former actuary here)
Yeah I read the research on
Yeah I read the research on it when bd was baking. It pretty much said unless you have family history of problems you won't ever need it.
UPDATE: B*tch wrote back to
UPDATE: B*tch wrote back to DH saying basically "Nuh-uh you are responsible for 50% of any and all medical care"
I drafted the email (which he sent) telling her to pull out page 16, copied word for word the text and bolded and underlined the section telling her she is 100% responsible for out of network costs.
It is about $1,000 of costs. She needs to learn her lesson, and I bet next time she will be damn sure to research what psychologist SS will be seeing.
ESPECIALLY now that skids are on my plan, everyone is following the rules if they want to get paid.
Virtual slap in the face to
Virtual slap in the face to BM2. Feels good, huh?
So if the kids are on your
So if the kids are on your plan, how do you keep providers from automatically billing you for anything not covered by the plan? We get random bills all the time from different providers who automatically bill dh because he is the subscriber. We don't even know where they're going to come from because she goes out of network on purpose too. So it's not like we can call them and try to head it off.
edited to add: her favorite trick is to use different ERs. She decided recently that SD12 needed an MRI, catscan, etc 3 days AFTER she got lightheaded at school one day. The school nurse had no issue with her remaining at school. When DH tried to talk to BM about it, she said it's too bad for us that "our" bills for the skids' "healthcare" are going to be "a bit high". For the record, He is court-ordered to pay nothing but child support, he bought them insurance only because he thought it was the right thing to do. He canceled it after BM discovered she could beat us with this new club and racked up 6k in bullshit tests, and she told him that she was keeping several future appointments anyway that are now going to cost us even "more" without insurance. We don't know how to stop her because the providers keep billing us because she tells them to. She claims that the providers already "pulled" his ins. information for the future appmnts and that we are therefore on the hook even though the ins. ended in the month PRIOR to these appmnts.
Two weeks prior, SD just had to go to the ER for her "sore foot" she'd had for days. God forbid BM just make a regular appmnt like a normal person! (that would not cost us enough.) Enter xrays and then a whole bunch of wack tests (like a urine test?!) at BM's request, of course, "since they were there". Seriously, this woman is a piece of work. But we're in a corner if we want to protect DH's credit, and it's 3.5 k retainer (that we don't have) to hire an attorney (We've already looked into it).
They've only been on my plan
They've only been on my plan since September (when we got married) so we haven't had an issue before this. My BMs (1 &2) aren't idiots.
BM1 is very reasonable. We are actually decent friends and coordinate A LOT on medical care for SD15 and SD12, especially SD15 since she is diabetic. Both BMs are responsible for 50% of medical costs so they tend to be fairly careful. BM1 and I work together with the insurance company to get SD the cheapest (but still good) insulin, test strips, etc. We were able to get a new DexCom system for about $200, which was great.
DH got laid off, so that is why I added all the skids to my plan. BMs knew their costs would go drastically up if I didn't do this, so they cooperated wonderfully. Both BMs sent me a list of docs skids go to so I could check if they were in network. All were. I told both BMs I would be happy to check any time for any in-network providers if they needed anything new.
SS6 just had a bunch of dental work done. The anesthesia was out of network (it was extensive work so he needed it), but BM2 discussed with DH and I (after getting an estimate from the company) and we all agreed.
The psychologist was from when they were on DH's policy and she didn't bother to check in vs out of network. Now that all the skids are on my plan, both BMs know that won't fly, especially because I work in insurance.
While they can be a pain sometimes, both of my BMs are SAINTS compared to many of yours. Thankfully they are not high conflict.
What does your decree say about healthcare costs? Ours specifies that they must use in-network providers where available except for an emergency. It also states that she must submit receipts from the provider within 30 days. If yours doesn't have details like this, it is worth getting it amended. I would be happy to give you ideas on what should be put in there. There are things not in ours that I wish were.
This is an excellent idea.
This is an excellent idea. Report her to the insurance company and also the NAIC (National Association of Insurance Commissioners)
If you PM me I can get you some contacts.
UPDATE #3: BM wrote back
UPDATE #3:
BM wrote back after we quoted the decree and said "Ouch, that was an expensive lesson to learn!"
Then she started blubbering about "Well, what if it is an emergency bla bla bla" even though the decree specifically states it doesn't apply to emergencies. We are going to clarify in an email (after reading this thread) that an emergency is LIFE-THREATENING.
Having a sore foot is not an emergency, and if she wants skids to get x-rays she must go to in-network hospital or urgent care center
Our BM would do similar crap.
Our BM would do similar crap. Except she would actually throw in some of HER PERSONAL medical expenses in the hopes that my DH would overlook them in the pile (skids were healthy but you'd never know it from the amount of medical visits. She had 6 MONTHS to submit medical and he had 30 DAYS to pay his half).