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Update: Hospital Billing

CastleJJ's picture

So DH received yet another medical bill from BM requesting reimbursement. This one was for $160 for SS' "OT services." BM's insurance isn't very good - that $160 out-of-pocket was for only 2 visits. I asked DH how long BM is going to continue to seek OT for related to SS' "sensory processing disorder." DH said "As long as she possibly can." SS already started football so there is no reason he can't use that to get his "issues" worked out. 

DH emailed BM yesterday about her request for the $250 from SS' throat scope. He name dropped, telling BM he called the hospital and the FOC, telling that BM the hospital said the deposit is refundable and the FOC said BM has to request reimbursement after insurance is applied, not before. BM backed down when she found out he contacted those entities. BM apologized, saying that she couldn't remember if it was before or after insurance was applied, but she didn't want to miss out on DH's payment if she got it wrong. Our BM is always on top of everything; like I've said previously, her 5 year plan has a 5 year plan... she is always manipulative and calculated - she knew darn well how/when to request reimbursement, she just thought we would blindly pay without asking questions.

BM then said she had insurance do a quote for SS' procedure. She believes it will be $1200 out-of-pocket, trying to claim that the scope was $11,000 before insurance... Giving birth to DD4months, which was an induction with multiple interventions, 3 days at the hospital, etc. was $12,000 before insurance; you can't tell me an outpatient pediatric scope down the throat with general anesthesia is that much. BM claimed that another reason she sent the request for $250 to lessen the blow of sending the whole $1200 bill at once, doing us a favor. DH told BM to wait until she receives the final medical bill with insurance's adjustment before requesting any more money. BM said okay, but informed DH that she has more medical bills coming. 

Does BM not understand that making medical issues for SS isn't the way to get to us? BM still has to pay the 60% majority of out-of-pocket medical costs, so it is still costing her a boatload if this is her new tactic to get back at DH. I'm hoping she doesn't continue because these past few months have been expensive for SS. 


stepmomnorth's picture

Well, stick to your guns for sure on the medical billing. You were right about paying your portion after the bills are finalized. This is the way that makes most sense. You'll probably have to check each bills she sends to be sure of your portion. Maybe you could call around about the throat scope cost as well, that's expensive! Is the scope necessary? Is there any way to get a second opinion on whether it's required? 

CastleJJ's picture

BM has sole legal custody. DH has gone to court multiple times since SS' birth to try to get joint legal, but due to BM living long distance, the courts won't order it, so DH has no input in medical decisions; he just has to fork out money for all the medical bills. It's frustrating to be court ordered ATM when BM is a hypochondriac. And we can't even get a second opinion during our visitation because we aren't authorized by the CO to make medical decisions, except in emergencies. 

stepmomnorth's picture

That puts you in a hard situation, especially with her being a hypochondriac and you basically have to agree and fund her over the top and costly medical decisions. My ex is like that sometimes, gets some crazy ideas in his head of what the kids need. 

CastleJJ's picture

We haven't had to pay out-of-pocket medical expenses in about 3 years because BM hasn't sought much medical care for SS during that time. I'm hoping this year is just a random influx and she won't turn this into the norm from now on. 

thinkthrice's picture

"Joint Legal Custody" isn't worth the paper it is written on.   The Girhippo Munchausened her way through the 3 ferals formative years, never giving Chef any info on their many medical and dental  so-called conditions, signing them up for every activity under the sun without Chef's consent then presenting him (read: me) with the bills.

Chef was overruled time and time again by judges, school admin, you name it.   These HCGUBMs will do as they please and get away with it and NO judge will hold them accountable....joint legal or no joint legal.

MissK03's picture

I'm not sure how often this happens but.. do you think one of the doctors might report BM if she keeps looking for "something" to be wrong with SS?

CastleJJ's picture

I don't think so. This is the first year in quite a few years that SS has received this much medical attention. Plus, BM keeps going through separate specialists so it's harder to track - OT and ENT. And from the sounds of it, BM reached out to the OT for an evaluation prior to asking the doctor for an order so the pediatrician may not be catching on. 

Ispofacto's picture

I would call the doctor and ask him about the diagnosis.  If you aren't convinced, allude to not believing SS has a diagnosis, and imply without saying that you are litigious and he/she could possibly get sued.  Doc would most likely drop SS as a patient.


CastleJJ's picture

SS has had croup a few times. I'm not arguing that. The scope found nothing though and the doctor isn't recommending further exploration, so that will be that. BM claims that SS has respiratory issues/chronic croup, and SS has confirmed some issues, though not convincing, when he talks to us, but it makes me wonder if it's something environmental at BM's because he doesn't have those issues here. If the ENT isn't recommending further treatment, then I'm not worried about her pursuing this further. BM isn't the type to get second opinions. 

The only diagnosis I am skeptical on is the sensory processing disorder. My brother has ASD and he had a sensory processing disorder as a kid - you don't just develop it overnight. And the timing is fishy, because BM claimed he developed it around the time DD was born. But we've reviewed the OT notes and they have documented deficiencies so he will continue to receive OT. I think SS may have deficiencies, but I think it is related to growth - his muscles and tendons are tight due to growing a crazy amount in a few months, hence the toe-walking they are treating. BM is claiming the toe-walking is related to a need for stimuli due to sensory issues. The OT notes don't identify the cause, just that he has noted deficiencies and they are working to treat them. 

NotYourAverageStepMama's picture

to of forgotten this detail, definitely sounds like she is just trying to get some extra money from DH and hope he doesn't notice or ask too many questions about it. Plus there is no way the surgery was that high so definitely good idea to wait until the final bill comes in after insurance. Sounds like it is all about trying to get attention and stay relevant since you and your DH bought your house and had your DD.