Payment of Medical Bills

North Carolina Divorce Law Divorce and Separation Answers
1

What’s the question?
What is DD and DH? Dependent Daughter (DD?) Divorced Husband (DH?)

If the question is do you pay the bill, then I would say yes, unless the ex has another job. If you’re not required to carry the child, but you did (because you’re a good daddy), then you pay the bill and keep records of it for reimbursement from the ex. OR you can not pay the bill and have collections started on the ex I suppose. Are we talking about a lot of money? Is it not covered by the insurance you have on the child?

2

oh my! Didn’t realize I didn’t have the whole story there! [:I]

DH = dear husband (on a good day! LOL)
DD = dear daughter

Basically, what I am wanting to know: Is my husband responsible for paying these (or any other) medical bills for his daughter?

There have been other doctor visits in the past where he paid the co-pay. One of these providers sent him a bill for the balance due. When he called them up to dispute the bill he was told that since he paid the co-pay he agreed to pay the entire bill. Personally, I think that is bulls&*$#, but he paid the bill. A note was included with that bill stating that he was not responsible for payment of future medical bills and all bills should be sent to the Ex for payment. The Ex has always taken their daughter to all doctor appointments and she is the one authorizing treatment. I have had others tell me that the person who took the child to the doctor is the responsible party for payment of bills.

My husband pays his child support on time every month. He has made co-pays to doctor visits, we have bought her school clothes, school supplies, paid for school pictures, bought clothes for her to wear at our house, paid for summer camp…the list goes on and on. ALL of which was over and above what he is paying in child support. So it’s not like he doesn’t financially support his daughter. BUT, we don’t have the money to fork out for every little thing. We have a daughter together who is in daycare, which ain’t cheap. We have our regular household expenses on top of what is going out for child support and the extras that we are paying for.

The balance of the bills is not alot of money, but it’s the principle of the thing. They’re BOTH supposed to provide for their daughter financially. I don’t know if the Ex has another job or not. She had a part-time job that she quit because she is going to nursing school. She only had that job for a few months. Last year she had a Pell grant while going to school and I suspect that she got another one for this quarter/semester and that’s what she’s living off of.

There’s no way the Ex would ever reimburse for medical expenses. She’d laugh in his face. She left a voicemail on his cell phone telling him that she was taking their daughter back to see the therapist and that he WOULD be paying for the visits or she’d call his parents and tell them about a child he has with another woman that they don’t know about. He’s calling her bluff on that one.

The insurance has paid some but there’s been disputes about the charges. Too long to go into detail here.

3

If the insurance for the daughter is now in his name, then he is responsible for the payments. None of the personal stuff matters to the insurance company - it’s his policy, therefore, it’s his responsibility. If you turned on the electricity in your name, the electric company wouldn’t bill your neighbor for the cost - they would bill you, because you opened the account.
When you sign up for insurance, you sign a contract agreeing to their charges. Unless they’re not covering a contractually covered service, you are obligated to pay. You can minimize your amounts due by ensuring you ALWAYS take your child to a provider that is networked with your insurance company - CALL YOUR INSURANCE COMPANY because just because a provider accepts your insurance, doesn’t mean they are a networked provider. If they are non-networked, this means they don’t have a contract with the insurance company and they can charge above and beyond what the insurance covers, and you will be responsible for the difference. It’s not bs, it’s the way insurance works. So, choose networked providers, and always call to see if you need an authorization from the insurance company or a referral from your primary care physician before you go to any appointment. That can also make a big difference in what you have to pay.

Now, on to your other question…

His options for financial recourse:

  1. Pay the co-pays and any overages or deductibles that his insurance charges, and then send the ex a bill for half afterwards, that is his prerogative.
  2. However, if his daughter is seeing a therapist on his tab, and he doesn’t want her to, because he doesn’t want to be responsible for the charges, then he should call the therapist directly and notify them of the situation. Maybe find a therapist that is networked with your insurance, if this one isn’t.
  3. Either that, or hold on to the insurance cards and go with the ex to daughter’s appointments, so that he is the one authorizing treatment, instead of her going to appointments without his knowledge or consent, and then being hit with bills later on.

**My husband’s first wife has a tendency to do this… every Christmas she’ll send a 1-inch stack of “bills” from the prior year’s insurance billings, and expect him to shell out $2-$3K in December to finance her Christmas. He did this every year until he married me!!! I used to work in insurance, so I took her bills and matched up all the dr statements with the insurance statements… turns out from her $2300, only $200 was legitimate. She was charging him for the doctor’s statements, plus the insurance payout amounts… and he didn’t know how to match up the statements or interpret them, so he ws paying whatever she asked. Boy, was she pi$$ed, but not because we were stiffing her - because she got “Caught” in her scam. But, what she was doing was totally wrong, and she won’t pull any fast ones again… Also, she was taking the kids to non-networked providers, which meant both she and my husband (they’re supposed to split 50/50 the post-insurance costs) were paying much more than they needed to in co-pays and balance billings. So, when I explained to her that she could save HERSELF money as well, by using networked providers and getting authorizations for specialty providers, she was actually happy…

In your case and in ours, ultimately, this should be about getting healthcare for his daughter, and keeping his credit straight. Don’t worry about what the ex does/doesn’t do financially. Worry about keeping your daughter healthy, and keeping your credit in good standing. Just do what you can to minimize the impact, such as requesting that your husband accompany her to doctor’s appointments to present his card, or at least being notified ahead of time of the appointments, so he can check on the status of the provider.
Another solution: With my children, my nanny takes them to appointments since I’m at work during the day. I call ahead to the doctor’s office, explain the situation, and they fax me the relevant paperwork. I fill it out, and fax it back along with a copy of the kids’ insurance cards, along with a letter stating I authorize Ms. Nanny to take them to the app’t. That way, the doctor’s office has all their information, without the ex ever having the card in her hand. And for emergency treatment such as at a hospital, they will treat in the absence of a card, so long as they receive it during the visit, so don’t let her tell you that she needs the insurance card at all times in case of an emergency. In an emergency, you would be notified anyway and at that time could give them the information. Or, she can give the insurance info and the triage at hospital can call the insurance company to verify coverage is valid until the card is received.

4

Is the therapist necessary?
Do they have joint physical custody, or just joint legal? If they have joint physical custody and father is carrying insurance, then normally, they should split any medical cost that is not paid by the insurance company. If mother has primary physical custody, then I would assume that she pays co-payments or any cost not covered on insurance. Primary physical custody means that she has the responsibility of care and maintenance of her daughter on a daily basis. The legal custody means that they jointly share decision making on school, medical, religion for their child, along with a few other things like if one parent wants to move out of the country…
Your husband needs to speak with the doctor’s office and explain that he is providing insurance but that payment needs to be gotten at the time of service or that the bill should be sent to the ex. I don’t know if he is legally responsible to pay for medical bills since he was not court ordered to, but being realistic, he should be open to the fact that expenses with children are going to come up. You two need to sit down and discuss what’s worth arguing about. Pick your battles. The clothing that you purchase, school supplies and other things are just going to be expected. You can either refuse to purchase things and deal with the child not having what is needed or pay for it and forget it. I have had to remind myself sometimes daily that it’s not worth my husband arguing with his ex over me spending $20 on a couple of new shirts for my stepchildren (she is supposed to buy their clothes) or that their mother didn’t give them lunch money again. They have share joint legal and physical custody with equal time. You would figure with shared custody like that, she pays for anything during her week or at her home, and we pay for anything during our week or at our home. We do buy clothing, shoes, and school supplies that stay at our house. He still pays her $500 a month child support, give them lunch money to pay for her weeks, pays 1/2 the summer daycare bill, carries insurance, buys medication every month for the oldest son and pays the co-payment for that doctor visit every month with no reimbursment. He also is the one that schedules dentist appointments and gets their hair cuts which he pays all of… With all this that we pay we KNOW that it doesn’t cost her $500 a month to take care of her sons for two weeks out of that month but sometimes it just isn’t worth arguing over.
In my own opinion, there doesn’t seem to be a lot that can be done, unless you drop the insurance on the daughter, and force mom to cover her. That’s not a chance I would be willing to take though. One option I could suggest is that he could agree to reimburse her 1/2 the co-pays or other medical expenses 30 days after being presented with a paid receipt by her. This way the bills are being paid and even though it’s going over and above what he pays in child support it shows a willingness to work with his ex to take care of their child. Just my opinion though. Document everything and make adjustments as needed.

5
quote:
[i]Originally posted by stepmother[/i] "[br]Is the therapist necessary?"

Not to sound glib, but it depends on who you ask. From what DH and I can tell, it’s not done her any good.

“Do they have joint physical custody, or just joint legal?”

The Ex has primary physical custody and they have joint legal custody.

“Your husband needs to speak with the doctor’s office and explain that he is providing insurance but that payment needs to be gotten at the time of service or that the bill should be sent to the ex.”

Exactly what we’re going to do.

“I don’t know if he is legally responsible to pay for medical bills since he was not court ordered to, but being realistic, he should be open to the fact that expenses with children are going to come up.”

He is open to that fact. We both realize this. However, we’re not the Ex’s personal bank either and there’s just some times we can’t pay for things. We have our own houselhold to support.

“You two need to sit down and discuss what’s worth arguing about. Pick your battles. The clothing that you purchase, school supplies and other things are just going to be expected. You can either refuse to purchase things and deal with the child not having what is needed or pay for it and forget it.”

I wasn’t meaning to come across as complaining about this or that there have been arguments between DH and the Ex about this. We’re not going to let his daughter do without if we can help it. That’s why he’s carrying the medical insurance on her. It’s important that she have medical coverage. It was just me venting my frustration over us being the ones always doing the right thing for his daughter while the Ex just goes on her merry way.

“One option I could suggest is that he could agree to reimburse her 1/2 the co-pays or other medical expenses 30 days after being presented with a paid receipt by her. This way the bills are being paid and even though it’s going over and above what he pays in child support it shows a willingness to work with his ex to take care of their child.”

This is a good option but she wants him to pay for everything with no effort or obligation on her part.

Appreciate your response!

6

If your husband has joint legal custody of his daughter then he should plan to go speak to the therapist on her next visit. He should have part in the decision on whether to continue care. Since she has primary physical custody then they should be able to send the bills to the child’s residence, but I may be wrong. I’ve never carried insurance on a child. But ivyalmighty has it right that his name would have to be on it since it’s his name on the insurance.

We all need to vent at some point. I have complained rather loudly at times that it’s not fair for my husband to have to pay so much to her and still take responsibility for all this other stuff too. I’ve come to realize that it’s not going to change and it only wastes my energy being mad about it. I still hide clothes the night before the boys go back to their mothers, this way she doesn’t end up with brand new clothes at her house that I bought while we end up with junk that is too small or stained. I make sure to wash whatever they wear over and that is what they wear home. It’s all I can do but at least I know they have nice clothes to wear when they are with us. I feel bad that essentially they are wearing the exact same clothes every Monday but I’ve learned that if something new goes to their mother’s we never see it again. We can’t afford to buy clothes for her house too.
If the ex is playing him on money then he should put his foot down. My husband explained to his children the first time they said, “Mom told us to tell you to buy…” what he paid in child support and what child support is supposed to be for. He didn’t bad mouth their mother but he let them know that if she’s telling them she doesn’t have the money that isn’t exactly true because he pays her. He told her no on several occasions that she has asked for him to pay her back on something that was unecessary and soon she stopped asking.

7

“Your husband needs to speak with the doctor’s office and explain that he is providing insurance but that payment needs to be gotten at the time of service or that the bill should be sent to the ex.”

Exactly what we’re going to do.

Please remember, just because you ask them to send the bills to the ex, doesn’t make them her responsibility. The insurance is in your husband’s name, therefore, he is responsible for payment. She can be notified of the amounts due to the doctor’s office, but ultimately the bills will go on your husband’s credit if she chooses not to pay them.
And the co-pays can be paid up front - many doctor’s offices won’t provide service without the co-pay up front, these days. But that doesn’t always cover the amount due AFTER insurance pays out. The doctor’s office can’t always figure out that post-insurance amount up front, therefore, the ex and/or the doctor’s office can’t be expected to provide an amount for service up front.

If she doesn’t want to have anything to do with paying for doctor’s visits, then take away the insurance card and take care of it yourselves. At least you’ll know where/why she’s visiting the doctor.
That’s like giving someone a credit card and then getting mad when they send you the bill. If the insurance is in your husband’s name, then make the doctor’s appointments on his terms, so you’ll feel like you have some participation in the expenses.

8

Ok I’m confused about something…There was a guy that I dated for a while before I met my husband. He had a daughter that he really had nothing to do with because he was not sure that the child was his and he and the mother had never been in a relationship. He was court ordered to pay child support and to carry insurance. This is a child that lives in another town that he has never seen or had any contact with. He pays child support and covers insurance but no other dealings with. He was not billed when the mother takes her to the doctor. He does was never even aware when the insurance was used or for what. He would take his new insurance card to the DSS office in the county where the mother and daughter lived and they would get it to her. Could this have been something the mother worked out so that he didn’t have to continuously contact her? Just wondering…

Also, I do know that if the full amount of a bill is paid you can request that the insurance reimburse you for the amount covered instead of the doctors office.

9

Stepmother,
It sounds like the mother was giving the doctor’s office her address, and the bills were going directly to her. The address the doctor’s office has on file is the address the insurance company will use. The ex of the man you were dating was probably just being responsible, and paying her/his bills in full as they occured.

What I was telling this poster to beware of, is that the responsibility for payment STILL falls on her husband’s shoulders, even if he isn’t made aware of any amounts due.
Example: My husband’s first wife receives all bills, from both the doctor’s office and Tricare, because that is the address she lists to be billed to. We don’t see anything until she sends the above-mentioned Magic Stack in early December each year :slight_smile: If my husband’s ex does not pay an insurance bill or a doctor’s bill and it goes to collections, all the correspondence goes to his ex’s address, because that is what is listed. So, it is possible for him to have an unpaid bill in collections and never konw about it, because they don’t have our CA address, only the home address of the patient. In the past, my husband was never aware of what/why his insurance was used until he received the bills at Christmas. The ex would pay all the bills in full and then ask for $$ back at the end of the year. With me in the picture, that has changed, because he has contacted the insurance company and asked that a copy of all EOBs be sent to our current address, as well. …Of course, she was also being shady and asking him for waaaaay more back than she was actually paying out, because he didn’t have the org. skills to marry up the doctor’s statements… Did I mention that already? Oh yea… sorry, it still just kills me that she had the balls to do it, and he never caught it! He paid THOUSANDS to her that weren’t owed.

And yes, you can pay a full amount up front and then request reimbursement after insurance goes through. But having worked in the field, I can tell you it’s not so easy to get your money back once you pay up front. It can take months for the bills to run up and down the submitting/processing/resubmitting chain… and I doubt that the ex-in-question will agree to paying $300-$500 up front for a doctor’s visit and then wait 3-5 months for reimbursement after processing.

10

Dear jillb:

Greetings. No, if there is no order then he is not obligated. Good luck.

Janet L. Fritts
Attorney with Rosen Law Firm

4101 Lake Boone Trail, Suite 500
Raleigh, North Carolina 27607
919.787.6668 main phone
919.256.1665 direct fax

301 McCullough Drive Suite 510
Charlotte, North Carolina 28262
704.644.2831 main voice
704.307.4595 main fax

1829 East Franklin Street, Bldg 600
Chapel Hill, NC 27514
919.321.0780 main phone
919.787.6668 main fax

The response posted above is based upon the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with an attorney, fully explain your situation, and allow the attorney sufficient opportunity to research the applicable law and facts required to render an accurate opinion. The basic information provided above is intended as a public service but a full discussion with an attorney should be undertaken before taking any action.

11
quote:
[i]Originally posted by JanetFritts[/i] [br]Dear jillb:

Greetings. No, if there is no order then he is not obligated. Good luck.

Janet L. Fritts
Attorney with Rosen Law Firm

4101 Lake Boone Trail, Suite 500
Raleigh, North Carolina 27607
919.787.6668 main phone
919.256.1665 direct fax

301 McCullough Drive Suite 510
Charlotte, North Carolina 28262
704.644.2831 main voice
704.307.4595 main fax

1829 East Franklin Street, Bldg 600
Chapel Hill, NC 27514
919.321.0780 main phone
919.787.6668 main fax

The response posted above is based upon the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with an attorney, fully explain your situation, and allow the attorney sufficient opportunity to research the applicable law and facts required to render an accurate opinion. The basic information provided above is intended as a public service but a full discussion with an attorney should be undertaken before taking any action.

Thanks for the response Janet. The therapist has sent two bills (referenced in my original post), a bill for a later visit and recently a consolidated bill of the first two bills. Each time a note has been written on the bills advising that my husband is not the responsible party for payment, that he did not take his daughter to any of the visits and that he has not signed anything authorizing their treatment and/or accepting responsibility for payment. I think their argument is that since he’s the one providing the medical insurance and because he has paid some co-pays that he is agreeing to be responsible.

Questions I have:

  1. Is he responsible for payment of a balance due if he pays the co-pay or just because he’s providing the insurance?

  2. What is our recourse if they continue to send bills in spite of the fact he’s told them he’s not the responsible party, didn’t authorize treatment and didn’t sign anything agreeing to pay the bills?

  3. Should we request they send us any and all documents they have with his signature re: question #2?

12

JillB,

If your husband’s insurance is being billed, they will consider him responsible for any and all costs associated with service. He will have to pay the insurance co-pay AND balance due to be straight w/ the insurance company. They will most likely tell you “not our problem” for the current outstanding bills. Your best choice is to pay all the bills so if/when you ever end up in court again over the daughter, your husband can show he is compliant and generous in caring for his daughter.

Definitely request signature documentation for authorization from the counseling firm. It will force them to own up to their practices and will help you in any further issues. However, I still think it’s best to allow the daughter to go to therapy, though. Call the therapist and schedule some family sessions so you at least can all benefit from the insurance billings.

You can contact the insurance company and ask how you can handle the ex using the insurance for services you haven’t authorized. In the meantime, he needs to stand up and take the insurance card away from the mother, if he truly feels she is using the insurance willy-nilly.

And you not being able to see that the counseling may be doing any good… good counseling can be like good parenting: you lay the groundwork for a happier person, but it can take years before the foundation that was laid is visible in a person’s actions. Also, if the relationship between your husband’s first family and his new family is acrimonious, it can undo a lot of the lessons his daughter may be learning in the counseling.

Instead of looking at it as the EX benefitting from the insurance coverage, remember that the coverage is for the DAUGHTER, so the ex’s benefit is neutral. She doesn’t gain OR lose anything by taking her daughter to the doctor on your husband’s tab. The daughter is the one who gains. If he yanked coverage, the daughter would be the one to suffer. The EX would still remain neutral - no money gained or lost.

-Ivy

13

Thanks for the reply ivy but you’re misreading/misunderstanding the issue here. Also, Janet has already answered my question as to whether he has to pay the balance and, since she’s the attorney, I’ll take her word for it.

14

Jill,

Court obligation to offer counseling services for his daughter is not the same as the obligation to the insurance company.
He is not obligated to pay for her counseling by the courts, I believe is what Janet is saying - Janet can you jump in and clarify?However, once the insurance has been used by the mother, the insurance company will see that as him being obligated to the balance. Two different entities here - obligation in the courts eyes and obligation in the insurance company’s eyes. Kind of like a credit card - if his ex had his credit card with his knowledge and ran it for her boob job, the court would say he wasn’t obligated to pay for the surgery, but the credit card company would make you jump through different hoops to prove the fraud.
Either way, if you intend to take the mother to court to get the $$ back for those visits, you still need to notify the insurance company to keep the claim from going into collections. You’ll need at least a letter from a lawyer stating you are questioning the validity of the charges. The insurance company can only bill the sponsor of the policy, which is your husband.
I have come upon similar situations because I worked in claim processing/submitting, so I’ve seen this happen and it’s a train that is very hard to slow down once it’s rolling. Unfortunately, that’s how they make their money. “You pay us now, and sort it out amongst yourselves later on…” that’s the mentality.

15

Ex has sole physical custody and DH and Ex have joint legal custody. DH is not court ordered to carry medical insurance or to pay all or a portion of medical expenses.

Ex was losing her job and her benefits so she asked DH to carry their DD on his medical insurance. He has been doing this for a year or so now.

Ex has been taking their DD to a thereapist. Over the weekend DH received two bills from the therapists office. One of the bills is from July 2006! The other is for a January 2007 visit.