Wait...what did you do?!
To start, the boys are covered under my insurance because DH's is garbage while mine is frickin' sweet. However, for about 2 months last year, the boys were covered under DH because I switched jobs and was waiting for new insurance to kick in. All of this didn't matter because BM had the kids fraudulently on Medicaid. She may still have them on Medicaid - I have no idea.
So I get a denied claim for a procedure YSS had done. Over a year ago. When the boys were covered under DH's plan but she put the procedure through on Medicaid (per her own admission).
So, WHY DO I HAVE A DENIED CLAIM for a procedure that wouldn't have qualified anyway because I didn't have that coverage at the time AND BM said she put it through Medicaid?
I'm curious at the answer to this, and to see if BM hands over the bill for the denied claim. DH has already told BM that so long as she did this BS, he wouldn't pay for their OOP medical care (one of the few things he wasn't COed to cover).
Bets or thoughts on what's going on?
- lieutenant_dad's blog
- Log in or register to post comments
Comments
She may not have updated the
She may not have updated the medical facility with the current coverage information... or someone at the practice might have made an error and used dated info. I got a denial once because I was with a new employer..but same insurance company... the insurance company itself said I was no longer employed.... but of course, they referenced the old policy, not my new one.
This is new insurance that we
This is new insurance that we got January 1 of this year. My employer changed companies, so I didn't even have this company last year when I started working for my new employer.
Basically, the kids' insurance provider has changed 3 times since this procedure was done. We have ALWAYS updated BM and given her copies of the insurance cards - I even request extra cards for her. I suppose it is possible that the hospital forgot to submit the claim and did it on the most recent insurance, expecting BM to see the error and correct it herself. I just don't know that it can be corrected now that DH doesn't even use the same insurance anymore either (his company was bought out, and he changed insurance after we transferred the boys back to me).
Well, I have no idea if this
Well, I have no idea if this has anything to do with it but BM also put the skids on Medicaid frauduently the whole time DH had insurance on them. I am 99.9% positive this was purely because BM did NOT want DH to know when she took the skids to Dr. and ER. I don't know what happened, I am guessing Medicaid figured this out and they sent DH $40,000 worth of bills spanning 4 years prior. DH wrote them a letter stating that no where would they find his signature or consent to treat on any of these bills. BM is COed to send DH any bill within 30 days of her receiving it and he is to pay it directly to the hospital or Dr. The hospital took all the bills off of his credit score and we never heard another word. We never thought anything about it because in the meantime, BM got married and we just assumed she was using her new husband's insurance. Which she eventually did but apparently she was scamming the system for quite some time.
I still worry that someday it will come back on him. Sigh. HCBMs - they're like herpes, they never go away.
That's my big fear - DH
That's my big fear - DH getting thousands and thousands in bills despite providing insurance because of BM. It seems like good parents are damned if they do and damned if they don't.
People in the legal field
People in the legal field seem to think we'd have a good case. DH was never notified by insurance or BM. Also, she would be contempt of the CO. Which would be funny so many years later after the last kid is already emancipated. Not to mention the fact she was married and somehow still getting Medicaid and Food Stamps despite her husband making good money.
unhelpful comment
I'm so glad I live in the UK and don't have to deal with any of this. Thank heavens for single-payer health care!
How were you able to cover skids??
BM is doing the same thing to DH. CO states DH has to cover SS but BM still has them on state healthcare and we don't know how she is getting away with it. How were you able to cover skids on your insurance? My company will NOT cover children that are non-bio, doesn't matter if you are married. (I would never cover SS but am curious)