Problem Managing the Unreimbursed Medical Expenses
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Anyone else have occasional problems regarding “unreimbursed medical expenses?” I already know you probably do. I’m not sure what chapter unreimbursed medical expenses is in the Divorcing a High-Conflict Spouse Manual. I just know that it’s in yours.
This is the wrap-up of a story that actually started in the post Following a Path from Dentistry to Impotence and extended a little further in 2005 Thanksgiving & Christmas Planning Debacle, Part III and Part IV. Overall, the unreimbursed medical expenses issue hasn’t actually been a big one in our history. This circumstance was different because PEW used the incorrect insurance cards for the boys’ cleaning. When it was repeatedly getting rejected, she had to pay out of pocket for the services and then expected me to repay her for the unreimbursed medical expenses “on demand.” No surprise there. Well, I couldn’t, but I did extend effort effort and courtesy to get the situation rectified with the actual dental insurance carrier. An unfortunate clerical issue permitted this issue to drag on for months. It started in October 2005, continued through December of 2005 (obviously) and didn’t conclude until almost February of 2006.
In the former post, I simply suggested that I would file the claim “long-hand”, submit the paperwork, and just send her the check when I got it. For obvious reasons, they wouldn’t send a check to her. My insurance. My claim. My check. I had no problem giving her the money, but I certainly wasn’t going to pay the immediate price for her oversight. She would have to wait.
In the latter post, by November 21st, 2005, she was asking me to call the insurance company and expedite payment directly to her. In Part IV of that series, there is a little more where I explain that the insurance company had no record of her submitting the claim form I sent her, so nothing was done. In light of this news, I had them email me a new one and took care of sending in the information myself. This was interpreted by the PEW as me “sticking it to her.” It doesn’t matter to such a self-centered freak that her failure to use the appropriate insurance cards led to the issue in the first place. It also didn’t matter that she probably never sent in the claim form to have the matter rectified. Yep, that’s me sticking it to her.
Just after Thanksgiving, 11/28/2005, comes this:
LM,
I took the children to see Dr. [Dentist] on Oct 18th because you said you checked with your insurance company and OK’d that he was in the network. I just got off the phone with [Medical Insurance Company] and they told me they rejected the claim for Dr. Dentist because there is no dental insurance on that plan. Last week you told me that they had not received a claim from me but they did. If there is no dental insurance that is fine, but then you are responsible for 62% of the $255.00 dental bill from October 18th.
You also told me that they would not re-imburse me and that the check would have to go to you. When I spoke to them they said I simply had to fax a copy of the court order and the re-imbursement would come directly to me.
Do you have dental for the kids or not? If so, who is it through. If not, please forward $158.00 for your portion of this bill.
~PEW
This is where it dawns on me that she used the wrong insurance cards because she mentioned the name of the MEDICAL insurance carrier. So, she used the wrong cards. Then, she sent the claim form to the same wrong insurance carrier. That’s why they rejected the claim and that’s why the ACTUAL DENTAL INSURANCE carrier told me that they didn’t have a record of a request for reimbursement. D’ohhhhhh!!!
Fed up, I send a ridiculously sarcastic reply to her email.
PEW,
Thank you for the voice mail and email regarding the ongoing dental debacle and the education regarding what proportion of costs for which I am responsible. I don’t think you could make this whole dentist thing more difficult if you tried. Let’s go over a couple of things:
#1 – The children have Dental Insurance and Health Insurance.
#2 – The Health Insurance is with [Medical], for which I gave you multiple copies of insurance cards back in June.
#3 – The Dental Insurance is with [Life & Dental], for which I gave you multiple copies of insurance cards back in June - at precisely the same time as I gave you the Health Insurance cards.
Now, hindsight being what it is, I’m wondering if [Dr. Dentist] could have taken care of all of this had you given him the appropriate insurance card. I’m gathering by your voice mail, you probably gave him the [Medical] card.
Further, I emailed you just last week with the fax claim hotline for [Dental], so why you’re calling [Medical] this week escapes me.
Now, attached is the dental claim form for [Dental]. SAVE IT for future use, you could probably bring it to their future appointments for Dr. Dentist to fill out for you AND perhaps even send it in on our behalf with no reimbursement necessary. Their fax claim hotline is (again) [800-FAX-CLAIM].
The contact numbers are on the Dental Insurance cards if you have any further questions. I’m not sure that anything will change if you fax them our current custody agreement because I still think they’ll send the reimbursement to me, which I will in turn – send to you. I wish you would simply dispense with the paranoia as this is at least the 5th or 6th time I told you I will send it directly to you upon receipt, more than enough evidence of my cooperation in this regard should I suddenly decide to adopt the foolish idea of not giving you back the money to which you’re due reimbursement. No matter what you try to do, if they should send the reimbursement check to me anyway (which is what they told me they will do), I will send it directly to you immediately upon receipt.
Good day.
~LM
We all know how much being clear, direct, and abundantly factual helps matters such as these with the PEW.
LM,
I think I would have remembered if you gave me a card for [Dental]. Never got a seperate card for dental….never. Also, I asked you to double check [Medical] in Sept, why would I say that if I HAD another card?? I am very organized with these things LM, trust me I am reasonably sure that you are the one that screwed this up. Either way, I will re-submit the claim to the correct company and fax the court order and hopefully, the check will come to me instead of you.
Thanks again for your continuing to make my life more difficult than it has to be.
~PEW
Of course. Her organizational skills are without question, clearly. OF COURSE, she MUST have told me [Medical] back in September, which would then prompt me to call [Dental] to confirm that Dr. Dentist was in the network. Then, in a deliberate attempt to force her to pay out of pocket and for no other reason, I would confirm for her that Dr. Dentist was in the network, knowing she would use the wrong insurance cards because I really didn’t give her the dental plan cards, and my DIABOLICAL plan to delay reimbursement of the unfathomable sum of $158.00, conceived of and deployed months in advance - will have been an unmitigated success!
Only from the mind of a psycho ex can such a scenario even be possible.
Apparently, she would repeatedly call the Dental Insurance Company to check the status of the payment.
LM,
I spoke to [Dental Insurer] and the payment for $255 was mailed on the 5th. You should be receiving it today and I would appreciate it if you would forward it to me immediately.
~PEW
Received on 12/7/2005. After nearly 2 weeks, I still hadn’t received the check. I called the insurer to ask for an update and didn’t get good news. Apparently, when they mailed out the check, they forgot to include the “direction” that is part of our street name. This is particularly bad because there is a similar street locally that doesn’t have the “direction” as part of its name. So, who the hell knows what happened to the check. On the same day, 12/19/2005, I send her an update…
PEW,
I just wanted to let you know that I called the dental claims line this morning and they’ve told me that the checks went out on 12/7/05. However, they also told me that they’ve sent them to the wrong address, failing to put the “[Direction” in “[Direction Street Address].” Sometimes the post office realizes the mistake and forwards the mail to me, sometimes they don’t and the mail ends up being returned to the originator. As of today, I’ve still not received anything. While [insurer] has (today) made the correction in their system, all we can do at this point is wait and see what happens with the mail.
Sorry.
~LM
Total failure.
LM,
Well, more importantly is that the last support payment I received was on 12/1. So not only do you refuse to reimburse me for the dental bill, but you “forgot” to make your support payment right before Christmas. I find this interesting when you are trying to convince the world that these children are important to you?
~PEW
At the time, I had been dealing with multiple doctors appointments having just been diagnosed with a form of skin cancer, the extend of which was not known at the time. For obvious reasons, I had no intention of disclosing my medical situation with her. While I was figuratively “late” with a single payment, I was paying in advance as I am billed at the beginning of the month for totals due by the end of the month. Notice how she has spun the situation to be I am “refusing” to repay her for unreimbursed medical expense which is clearly not reality. Worthy of note - you’ll notice the common theme among those entitled ex-wives who connect the giving of money to them as being the proof of the children being important to the payer of funds.
PEW,
I’ve sent two checks last week. If you must know, I was dealing with multiple doctor’s appointments on Friday and Monday because I may have some form of skin cancer.
Not that any of that matters to you, but yes, dealing with that meant I forgot to send a check on Friday 12/9. I sent a check on 12/12 and a check on 12/16 and this week’s check should get everything squared away.
I will reiterate one more time… a little due diligence on your part is what created the dental reimbursement issue. Even after discovering your error, you still took a month to submit the claim. The dental debacle is your creation. Speaking of which, do you need new copies of the Dental Cards or did you find the ones I gave you back in June?
~LM
It wouldn’t do any good.
LM,
No, you never gave me copies of the dental cards in June, in fact I have an email from you dated June 19th that says, you forgot to copy the dental cards for me. Would you like me to forward it to you?
I seriously doubt that you have skin cancer. It doesn’t run in your family, you’re not fair skinned….Relax, I’m sure you’re not going to die.
~PEW
She lied, or should I say, told a half-truth.
PEW,
No, you don’t need to send me the email. I have one from June 15th thanking you for reminding me to bring them. I forgot when I returned the boys the weekend of the 17th and delivered them to you when I picked them up for the week of the 26th. None of that matters now, I will send you new copies ASAP.
Also, I don’t appreciate your sarcasm and long-distance diagnosis. I let the doctors tell me what I have or don’t have. I was simply pointing out that I was preoccupied with those doctor visits and wrote the check only 3 days after I normally would have.
~LM
Reality doesn’t crack the thick skull of the delusional…
LM,
Whatever on the insurance cards, never gave them to me.
As far as diagnosing you or sarcasm, I think you are reading into what I wrote. It was a comment because I’m not really sure why you were telling me that. I’ll tell you what though, I’m thinking the same thing you’d be thinking if I told you I had a potentially serious condition. God I hope nothing happens to you, you’re such a special person to me. Let me know if there’s anything I can do for you. Feel better soon.
Love ya.
~PEW
*gulp*
Another week goes by and on the day after Christmas I get…
LM,
I don’t know if the support conference is going to be re-scheduled since you are 3 weeks behind. So maybe you can take them Thursday after that meeting? I’m finding it hard to believe that the check from the dental insurer hasn’t gotten to you yet, since it was mailed on the 8th of Dec??
~PEW
As if the explanation of what had transpired never happened…
PEW,
Unfortunately, I cannot account for mail delivery as all checks for child support have been mailed. My last statement from the system shows me with an $8.77 credit, and I expect that my next statement will reflect the same. I am not, nor have I ever been 3 weeks behind, but if it makes you feel better to continue stating so, feel free.
I’ve already explained to you about the fact that the Dental Claim check was mailed to the wrong address a week or so ago. I don’t know if the post office will send it back to [Dental] or find the error and forward it to me. Fact is, I’ve not received it yet and no amount of your continued badgering of me about it will make that change.
~LM
And on and on and on we go…
LM,
The system does NOT show you as having a credit. We both log into the SAME system and mine is showing a balance of $563.00. So yes…..you’re at least behind two weeks and if you add in the dentist check that’s another $255.00. The support order is for $286/week and I only received 2 payments this month, one on 12/1 and one on 12/20. That leaves 3 weeks in the month of December where I havn’t received a payment. It’s out of my hands though, I called DR on Thursday and asked for enforcement, which they agreed to because you are PAST DUE. First you recieve a letter, then they issue a warrent. It’s very simple.
~PEW
I don’t know what system she was looking at and clearly, my lack of concern shows confidence that I’m up-to-date on my child support payments. You’ll notice that now it’s $255.00 I owe her, not just my portion of that $255.00. She’s a moron because even the dates she mentions are right in line with my payments every two weeks. She just hadn’t yet received that third distribution from the CS unit. I was ahead for the month by $8.77. It showed received on the website whether she had actually received it or not.
I had sent her new copies of the Dental Cards and she received them on January 3rd. In response to my asking her if she received them I get this…
LM,
I did get the new cards. Thank you.
LM, I really wish you would consider moving back up here. Maybe DW would consider it if POE could find employment up here or something. They don’t have family down there do they? Her business is mobile isn’t it? Your kids need you.
~PEW
Oh, sure! DW will leave. Her ex, POE, will just get a new job and move close to PEW with us because PEW demands it. After all, “your kids need you.” Everyone can just drop everything and change their lives to accommodate her.
I didn’t reply.
FINALLY, on January 11th, 2006, I got the check!
PEW,
Got the dental reimbursment checks yesterday. Dropping a check to you in the mail today.
~LM
She replied with a simple, “Thank you” and thus, ended the debacle that was the unreimbursed medical expenses due to PEW’s amazing organizational skills.
February 2nd, 2010 at 2:39 am
Love ya? Could she be anymore transparent? Coupled with the ‘the kids need you’ it’s clear she wanted you back. Or wanted a tighter hold on you.
February 2nd, 2010 at 9:09 am
She only said she cared because you are worth more alive than dead. She needs you to be alive to collect CS. Yes, the kids do need you, but I doubt she really believes that.
February 2nd, 2010 at 1:41 pm
It always mystified and infuriated me when the court would hand down orders requiring cooperation between the parents, such as “share unreimbursed expenses.”
Any order that requires cooperation by my PEG is guaranteed to cause major problems. Sharing expenses is not an unreasonable order, *when they parties involved are reasonable*. With a High Conflict ex, orders like this created nightmare scenarios like the one described above.
The courts really need to be educated about identifying high-conflict/personality-disordered parents and issuing orders that do not give these nutjob opportunities to create conflict and wreak havoc.
February 2nd, 2010 at 3:27 pm
My husband’s court order specifies splitting 50% of the medical expenses. We always send his PEW copies of the medical bills and request her half to be paid. She refuses to pay and we are forced to pay the total to avoid credit and financial problems. Of course she’s a doctor happy woman too. She takes my step-daughter to the doctor at the first sign of a cold. Our state makes it difficult and financially draining to go to court over the matter. Splitting medical costs is frustrating when they don’t get split! And the woman has the nerve to ask for us to reimburse her for half of a dance class!
February 2nd, 2010 at 3:34 pm
oh what an icky sticky mess that was! can’t believe she was (correction: is) that much of an idiot…from the beginning of that blog to the end, what a fustercluck!
ok i’m on the opposite side here as far as: we have had the “share unreimbursed medical expenses” clause for years. i don’t want to sound like a ___ but i’m only stating the truth that since birth, i have paid for every copay for doc visits and rx’s. and there have been MANY. no our child doesn’t have any serious problems, he’s just had many “small” problems (as in, colds would always lead to ear infection+sinus infections, etc.). it’s always been strep throat or something it seems every month or so. anyways, since birth, i have kept records from walgreens and asked for statements from the clinics as far as the copays. i asked for half reimbursement formally including the records in the requests every quarter or so. not one word in response. ever. i asked if perhaps he was going through a difficult financial time and that is why he doesn’t respond, that if that were the case i would understand. no response still. i gave up. it’s either pay an attorney to collect what i’d have to pay the atty anyways, or just let it go.
it’s well over a thousand dollars now. that’s not including me solely paying for the health&dental. no reimbursement. in these hard economic times (literally paycheck to paycheck barely making it) it just would be great if we both paid for our half and followed through on that.
i just–i’m not trying to sound “money hungry” or anything. and i’m not. at this point i’ve just accepted that i won’t get reimbursed for half and i don’t let it bother me anymore. like i said i’ve stopped even asking. what bugs me is the principle of it.
PE’s only answer to themselves with minimal exceptions.
February 2nd, 2010 at 6:09 pm
Reader, I totally understand! We have a few thousand in medical bills too but the attorney fees would probably equal the amount owed. The Ex’s know this and that is why they can get away with it. PEW is lucky that LM consistently follows through on his visitation, medical bills, and I’m sure other expenses. The principal bugs me too, so we will probably end up in court for principal alone. But it’s hard to decide what to let go and when peace at any price is or isn’t worth it anymore.
February 2nd, 2010 at 9:30 pm
MR..
“The courts really need to be educated about identifying high-conflict/personality-disordered parents and issuing orders that do not give these nutjob opportunities to create conflict and wreak havoc.”
AMEN!
The problem is they think they are just upset…I got told this by a custody evaluator with over a decade of experience. Duh!
February 2nd, 2010 at 10:02 pm
my husbands ex saved up uninsured medicals for 5yrs, my husband pays for medical & dental insurance and 50% uninsured medical. his pew does not want him to know when the kids go to the dr’s. she just constantly implies they are on death’s door and he is a dead beat dad for not paying the uninsured. I can’t tell you home many emails asking for the bills but they never came. she finally took him to court when oldest came to live with us and she was so furious she filed contempt for non payment of uninsured medicals. she would not give them to our lawyer before court and she had a spreadsheet with list per child of all bills. some had jsut balance forwards & was hard to match. family services was furious with her but still made my ex pay. no penalty to her. there wasn’t a contempt and there was strict stipulations set that she was to supply reciepts within 30 days of appointment and my husband to pay quartlerly. since that court date 2 yrs ago not one bill. she still says he is a dead beat dad again and he owes her money but no bills. also, because she did not cooperate with lawyer ahead there was no checking of her spreadsheet and my husband agreet to take her word. after the fact found out she listed orignal appointments then late billings, charged late fees to us ect…nightmare pew and this has been ongoing for 10 years, youngest is 18 now and she is looking at 40K no name colleges that we have never heard of and thinks we are just going to pay. it goes on and on. 5 more years and we are done, can’t wait.
February 2nd, 2010 at 10:06 pm
ps..the kicker is we think she carries insurance for the kids also for the last 2 years so the copays would have been paid by her insurance and there would not have been any out of pocket medicals but she lies unbelievably in court. courts need to fine, spouses who play games, fines for sending bills late, fines for not letting kids call dads, fines for keeping the kids on dad weekend, fines for calling dad’s deadbeat in front of kids when they never have missed a support payment or medical bill when given…courts need to implement a fine system and maybe the pews of the world would stop when there pocketbook gets depleted by their behaviour.
February 3rd, 2010 at 12:14 pm
I had nearly forgotten about this one, but long ago my PEG dinged my credit by somehow arranging the records with daughter’s dentist such that the all correspondence went to her, but my name and numbers were in the system for billing purposes.
One day I get a letter from a collection service saying I was past due to Dr. Dentist. Checked credit report and sure enough, they had already dinged my report.
Nightmare getting it fixed. PEG just sat on the bills and never told me about them, nor told the dentist about the issue. Her objective was to keep me in the dark regarding dental visits — she loved to have “control” by excluding me from participating in Dr. and Dentist visits. My role, in her eyes, was just to buy the insurance and pay the bills.
More recently she reneg-ed on a signed contract (not to mention court orders) to pay half of the uninsured Orthodontist. I ended up paying for the entire thing, again, to keep my credit from being trashed (they required a co-signed contract).
Only bright side of this is that she’s too embarrassed now to show her face at the Orthodontist office, so I take care of all the visits and never have to worry about being un- or mis-informed about what’s going on. Of course, I still tell her about every appointment (in a Low-Contact manner) — something she rarely if ever did for me.
February 3rd, 2010 at 12:23 pm
IN MY HUSBAND’S DIVORCE DECREE, HE IS SUPPOSED TO PAY “ALL EXTENUATING MEDICAL AND DENTAL EXPENSES”, YET HIS PEW HAS NEVER ONCE PRESENTED US WITH A BILL FOR RE-IMBURSEMENT. WHEN WE FILED AN AMENDMENT FOR CUSTODY, SHE CAME BACK THAT HE HAS NEVER PAID ANY OF THOSE EXPENSES, AND WENT AS FAR AS TO SAY THAT HE HAS REFUSED TO PAY THEM. OUR ATTORNEY SAID THAT SHE HAS TO GIVE US A COPY OF THE BILL WITHIN REASONABLE AMOUNT OF TIME TO PAY THE DOCTOR’S OFFICE WITHOUT LATE PENALTIES, AND THAT SHE PRETTY MUCH SCREWED HERSELF BY NOT EVEN ASKING FOR ANY OF IT. THAT WAS JUST RETALIATION FOR FILING FOR CUSTODY. ITS NEVER ABOUT WHATS BEST FOR THE KIDS, ITS ALWAYS ABOUT WHAT THEY WANT. THE PSYCHOS. THEY SHOULD COME WITH WARNING LABELS TATTOOED ACROSS THEIR FOREHEADS SO US NORMAL PEOPLE KNOW TO AVOID THEM!
February 3rd, 2010 at 1:51 pm
MR said: “The courts really need to be educated about identifying high-conflict/personality-disordered parents and issuing orders that do not give these nutjob opportunities to create conflict and wreak havoc.”
I disagree.
The courts do not need to turn themselves into lay-psychologists. They merely need to uphold the law, without bias.
If someone lies in court, and it’s obvious that they have lied, then the court should press charges for perjury. If someone openly defies a court order, they should be held in contempt. The court should be willing to punish the people who break the rules, no matter what their gender. Every time. I guarantee it would cut down on the bad behavior if a BPD absolute KNEW WITHOUT EXCEPTION that their misbehavior would cost them money or land them in jail. The court has the power to do this. They do not have the knowledge to diagnose.
The problem is, the courts have already tried to use way too much “psychology”. And it’s wrong. The courts believe it will emotionally damage children to have their mother thrown in jail. No harm if Dad goes to jail. It will emotionally damage the children if they are separated from their mother. No harm if they are separated from Dad. It will damage children if their mother has to pay a fine, but it somehow won’t damage the children if Dad is hit up with exhorbitant CS orders and other demands on his wallet.
That’s bad psychology.
Given that the courts have already demonstrated their inability to successfully apply psychological principles, the last thing in the world we need is for them to now believe untruths about BPD/NPD as well.
Think about it: even seasoned professionals have difficulty correctly spotting that diagnosis.
And: even very normal people temporarily behave in “crazy” ways during divorce.
Now I will be the first to say that I wish with all my heart that BPD/NPDs came with a great big neon sign warning people to never procreate with them. It would make everything so much easier.
But I would hate for that label to be incorrectly applied. And I would not expect non-psychologists to apply it correctly on a consistent basis.
February 3rd, 2010 at 3:53 pm
Good point JB, as usual. If the family courts did their jobs, a BPDs or High Conflict parent’s behavior would quickly result in either meaningful sanctions to deter the behavior, or even an award of custody to the fit parent.
No need for lay-psychology at all, just enforcing their own court orders and sanctioning bad conduct.
MR
February 4th, 2010 at 4:03 am
I think the solution is less family court. A big part of the reason you have things like the ex that runs the kids to the ER because they sneezed funny is because family law empowers them to do it. If mom didn’t have a bully boy to make dad pay unreasonable medical bills she wouldn’t compile unreasonable medical bills.
February 4th, 2010 at 7:59 am
The courts are doing their jobs!! And very well!! The first Golden Rule for attorneys is to get all the money from your client as you can, the second Rule is to help the “Opposing” attorney to get all the money from their client as they can, the third rule is, the judge is an attorney. If these Golden Rules are kept in mindthe whole business, industry of Family “Law” is much easier to understand. One only needs to look at the U.S. Health and Human Services site for abuse statistics for children to find that, indeed, the most dangerous invironment for a child to be raised in is that of the household with the SINGLE PARENT MOTHER.In fact well more than 62% of all abuse is at the hands of the Mother!!! So much for the “Courts” decicisions based on the “Best Interests of the Child(ren)!!!
February 5th, 2010 at 9:52 pm
We have the opposite problem. We can’t get my husbands PEW to take the kids to the dentist, orthodontist, etc. Even though he’s ready, willing, and able to pay his share of these expenses - and carries the insurance. In her mind, he should pay 100% of everything, and if he doesn’t then the kids suffer.
We have had instances in the past where she would put my husband down as the party responsible for payment, then use her address, and never pay the bills or tell my husband about them. We didn’t find out about them until we pulled our annual credit report.
Ah, the joys of parenting with a PEW.
February 9th, 2010 at 1:41 am
Just a comment on medical expenses.
Here in Michigan, child support has 2 parts, one part is base child support and part 2 is base medical. Base medical has a yearly threshold to meet before I have to pay unreimbursed medical. Together they add up to the weekly child support amount.
You have to look at the Friend of the Court, (FOC), paperwork, if your state has FOC do child support calculations and recommendations. You just might be paying for things that should be included in the weekly support. My ex tried billing me for things that were covered under base medical support, then she tried to get FOC to demand for reimbursement of unpaid medical expenses. They turned her down because she had not reached the minimum yearly threshold.
Good Luck to everyone
Keep the Faith.
Rich
February 9th, 2010 at 10:42 pm
If you haven’t already please sign and pass on:
http://petitionchildsupportreform.com/
Let’s fix this corrupt system and help end the suicides of many.