Tuesday, April 22, 2014

Medical Bills for Minor Children

Here is a basic guideline for medical reimbursement claims in Texas.

1.  Get clear copy of the medical bill for the child.  It should contain the child's name, the doctor information.

2.  Sign a HIPPA Release at each doctor that you take the child to so that the other parent can call the doctor's office and talk about the bill and/or to the doctor.

3.  Submit medical bill to insurance company.  You will eventually receive a "Explanation of Benefits" form that shows what the insurance company paid to the doctor an/or reimbursed you.

4.  Send items #1 and #3 to the other parent.  Normally this is done certified mail, return receipt requested with a confirming copy by first class mail.  If the certified copy comes back as "undeliverable" or "refused" do NOT open it -- leave it alone & put it in a safe place to show the judge if a contempt action is ever necessary.

5.  Don't let these bills build up -- you are normally ordered to submit to the other parent within 30 days.

6. Over the counter medications, parking, travel time, etc. is not reimbursable.

7.  Do not use the children to deliver these bills.  Keep them out of it!  This is "adult business" and only the adults should be involved in this matter.

8.  In the paperwork, the custodial parent is normally listed as a "contact" so that that parent can talk to the insurance company.  If this is a problem, ask parent (in writing) to submit whatever the insurance company requires to talk to you.

9.  If there are going to be some sort of large bill - such as orthodontics - include the other parent in the plan.  Let the other parent talk to the doctor or service provider to prove that the medical expense is "medically necessary".  If a child wants an optional service - like a nose job -- and the other parent does not agree then the judge will probably not order that parent to reimburse you and/or pay for a non-medically necessary procedure.

10.  If there are going to be payments made on a large bill, such as orthodontic treatment then encourage the other parent to enter into their own arrangement with the doctor's office to pay that doctor directly.  You would pay your portion & the other parent would pay their portion (normally 50/50) that insurance is not going to cover.  Doctors are willing to enter into 2 contracts with both parents - I've done it personally and it worked great.  It eliminated me having to submit a monthly bill to the other parent & he got to pay the doctor directly.

11.  If there is going to be a large expenditure and it's not an emergency, then try to get more than one bid and share that information with the other parent.

12. If medical bills are not sent to the other parent in a timely manner, the parent is still responsible for their portion (normally 50%) of the costs for the child.  But the judge will normally give the parent more than 30 days to pay.

For example, in one of my cases, mother submitted to father $10,000 in medical reimbursement for 10 years for their 5 children.  After he had not paid in 30 days, her attorney filed contempt demanding dad pay immediately.  Judge held that since mom was tardy in sending medical reimbursement claim that dad could enter into a monthly payment plan to pay the $10,000 without any interest accruing.

If you are going to file contempt against the other parent, you must come to court with evidence proving you did everything you were ORDERED to do by the judge AND you must have "clean hands".  Judges do not like people that try to use the courts to "punish" the other parent.  Judges expect people to act in a reasonable fashion & to co-parent their children together.

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