Help! BM Seeking reimbursement for Outrageous medical bills
DH has two children. SD12 and SD15. Per the divorce agreement DH gets to make major schooling Decisions and BM gets to make major medical/dental Decisions.
Here is the problem. BM Insists on using a out of network dentist for the kids which is VERY expensive. Then add BOTH kids are total pigs and never brush their teeth so every few months they require dental work. The last bill BM sent DH was over $500 for one office visit!
DH has told BM it makes no sense to use a out of network dentist when the kids have good dental insurance and could use a in network provider. BM refuses to change dentists giving the reason the kids are "Comfortable" there and they have always gone there. Total BS BUT for some reason BM is refusing.
So last winter DH sent BM a email stating going forward BM needs to find a in network dentist or he's not paying his share. BM never responded and last month sent DH a dental bill for over $500 from the same dentist. DH never paid it and now BM is flipping a nut emailing DH saying he's in Violation of the court agreement for not paying.
DH plans on not responding. Should he? If BM drags him back to court for being in "Violation" for not paying what is the best way to Prepare for this? Yes BM Legally gets to pick the dentist. BUT I can't Imagine when the judge sees the huge non-covered dental bills he would side with BM and allow her to Continue to use this dentist and expect DH to split the bills 50/50.
send dentist copy of email
Did BM pay the dentist directly and is requesting reimbursement? If so just keep resending email. Or does she just give DH's name as guarantor? If so the risk is the provider going after the guarantor, your DH. He could try telling the dentist he did not agree to pay out of network and see what happens. He could also indicate he will not pay anything further. This is a grey area I was worried about and closed the loop. DH had to go to court when SD#3 aged out of CS and I insisted a provision be put in at that time that BM is not allowed to take SS to out of network providers. There is almost unlimited liability there if BM wanted to be very vengeful - ER visit and so forth. I carry the health insurance, so I watch this very closely. It has also occurred to me that ultimately my name is attached to the health insurance card given at the provider's office and insist that DH stay very much on top of this. I check my credit report on a weekly basis as well.
BM pays the dentist Directly
BM Carries the dental insurance so she's the one that pays the bills. BM emails a copy to DH.
I would NOT pay half of
I would NOT pay half of anything. Even IF the CO states DH owes half of bills, BM is CHOOSING to not go to an in-network dentist. **Have DH offer in WRITING that he is willing to pay half for an in network provider. This way he covers himself if BM is saying "DH is refusing to pay." Yes, he is refusing to pay, but it is because of XYZ conditions that she is choosing.
BM did this with eyeglasses
BM did this with eyeglasses and DH refused to pay. She took him to court and he lost. I'd advise that DH pays what he would have owed of it was in-network, and then let her take him to court. They may still make him pay, that's the worst that can happen - but they may also tell BM to use an in-network provider, you never know. My DH didn't use an attorney for the appearance, since here, he didn't have to respond to her petition or anything , he just had to show up and argue. Since it didn't cost him anything, he figured why not try.
Get info from the insurance company about what they typically pay. I will say, BM has used in network providers since then. It also ended up clarifying part of the CO that said BM pays all costs up to 250, and they split it thereafter - BM took that to mean they split the entire cost if it's over 250, but the court clarified that it means they split the amount OVER 250. Not as good for BM.
BM also has to pay the first $250 per month
DH figured it out. If BM used a in network Dentist based on BM's insurance plan they would cover 80 to 100 percent of the dental visits. This being said using a in network dentist the Uncovered amount would be under the $250/month that BM is required to pay. So by using a in network dentist DH would not owe anything. We are thinking this is the main reason BM is Insisting on using a out of network dentist. BM is such a nasty controlling Vengeful b@tch she would rather pay more herself so DH gets stuck paying a high bill
Yes, let it go to court.
Yes, let it go to court.
Thankfully, BM here doesn't want to spend more money so she doesn't try to stick it to DH that way - I think the glasses were just a mistake, but DH shouldn't have to pay for BM's mistakes.
Also, is DH eligible for insurance that would cover this provider? If so, he should get it and insist it be used, though I know he can't until next open enrollment.
I woud let it go to court.
I woud let it go to court. Just have proof that you sent her the email about an in-network provider and then if she chose to go out of network, that is on her. I would ignore her and let her deal with that cost. I really believe that a sane judge would agree with you. It is unfair to put the cost of going to an out of network provider on a person who has no choice in the matter.
This is how we feel too
Now if the kids had "normal" teeth and only Required cleanings twice a year that would be Different. But the fact both kids get multiple fillings a year the Uncovered expenses are in the thousands of dollars. That's just crazy to pay that when the kids have dental insurance. Hoping if it does go to court the judge sees it this way also
I would think that is also
I would think that is also neglect!
I know some kids get an occasional cavity but for goodness sakes- are they even brushing???
They brush twice a day at our house BUT
The problem is both kids are lazy and do a half ass job. BM brushed their teeth till they were 8 years old because they were lazy and refused to do it themselves. Now the kids MAYBE brush once a day at BM's house. Both kids have NEVER flossed their teeth either which can't be good.
I'd also check to see if you
I'd also check to see if you can add them to your or your husband's dental plan if you carry one. You can give the dental office the info directly. If yours would cover them any better.
Reimburse only the copay that
Reimburse only the copay that would apply if BM used an in network dentist. If she wants any reimbursement beyond that she can research what the in network coinsurance would be. She is lazy, let her suffer.
If the kids end up with rotting teeth that cause them trouble for their entire lives when mommy ends up broke for not using the network dental coverage, make sure to vector them to their idiot mother for her failure to care for them. If the kids ever mention mommy's dental bills for their teeth, lock onto the message that daddy provided complete dental care for them that mommy refused to use.
Lather, rinse, repeat.
Contact the insurance company
One idea is to contact the insurance company to see if they will add the dentist to their network. Often there is a link on the insurance companies website to request a dentist be added. Enter the name and address and the ins co will reach out to them. Boom, done. Everyone happy.