Insurance ?

Krisx2

SD went to the Dr. office twice (1/23 &1/25) for a 'bronchial cough'. BM never informed us of the visits, but SD mentioned in one of her phone calls that she was sick. DH started the convo with BM about the illness (thus acknowledging being informed) because she usually just leaves him out of the loop entirely. 

She sent us a dental bill on 3/1 with a sticky note attached stating that she had received several EOB's from her insurance regarding the Dr. office visits and would be sending the bill as soon as it arrived. SD is primarily covered by BM and secondarily covered by DH. I have checked our insurance website daily and have seen NO submission of the Dr. office visits. SD told us yesterday that she had mailed a copy of her report card and "some bills from Mommy".

Here is my question: I do not think it is our responsibility to call the insurance companies and the Dr. office to get them to submit a claim to our insurance. I want DH to send the bill straight back to BM until it processes both insurances. Do you think that is reasonable?

The only reason I don't think it is our responsibility is that fact that BM has a copy of our insurance card and SHOULD provide it at the time of service. She didn't. Even then, I've talked to our insurance before and her insurance is supposed to send the claim to ours after they are done processing. They didn't. The past two years in a row I have had to spend countless frustrating hours on the phone figuring out ER claims and my most common road block was the fact that BM was the account holder, so no one wanted to work with me. I'm not doing it this time.

Do you think it is reasonable to expect BM to figure the claims out? Is there a good way to approach the topic? I expect that if we send the bill back and ask her to call she will flip a lid as usual and say that DH is unwilling to pay and burdening her. Thanks for any input.... 

Holly_1007

I guess it depends what your CO says? is BM supposed to have primary insurance and DH supposed to hold secondary insurance? what about the remainder, who pays that?

Is the insurance through DH's employer? I personally would have DH handle it, especially since it seems BM is failing to hand in the proper paperwork/insurance info to the doctors office. 

bebe11

I am not an expert in the insurance area, but I have 2 insruance coverages, one through my work (which is the primary) and one through my dh.  I give both insurance cards to the doctor (i really only had to do it once) and the doctor office or hospital should bill it all.  If the primary doesn't pick up everything up, then I would think the doctor has to re-submit the non-paid portion to the seocndary insurance?

To answer your question, I would probably ask that BM make that call to the doctor office to get the bills paid.  If they don't get paid and say they go to collections, who's credit would it effect, that is something else to take into consideration. Becauuse if it was my credit, I would probably take the time to sort it out.

Krisx2

holly71087:

I guess it depends what your CO says? is BM supposed to have primary insurance and DH supposed to hold secondary insurance? what about the remainder, who pays that?

Is the insurance through DH's employer? I personally would have DH handle it, especially since it seems BM is failing to hand in the proper paperwork/insurance info to the doctors office. 

CO says BM provides primary and DH provides secondary insurance. DH pays the after insurance remainder (which is why it is so important to process both insurances, otherwise bills can be hefty). DH and BM both have insurance through employers.  

Krisx2

bebe11:

I am not an expert in the insurance area, but I have 2 insruance coverages, one through my work (which is the primary) and one through my dh.  I give both insurance cards to the doctor (i really only had to do it once) and the doctor office or hospital should bill it all.  If the primary doesn't pick up everything up, then I would think the doctor has to re-submit the non-paid portion to the seocndary insurance?

To answer your question, I would probably ask that BM make that call to the doctor office to get the bills paid.  If they don't get paid and say they go to collections, who's credit would it effect, that is something else to take into consideration. Becauuse if it was my credit, I would probably take the time to sort it out.

That's kind of my reasoning as well. BM is the account holder and is the one who takes SD to the doctor (we live 8 hours away and SD hasn't ever been sick at our house). It is her credit in jeopardy. I'm just afraid of the blame game that will ensue.

Ginlyn0

Krisx2:

bebe11:

I am not an expert in the insurance area, but I have 2 insruance coverages, one through my work (which is the primary) and one through my dh.  I give both insurance cards to the doctor (i really only had to do it once) and the doctor office or hospital should bill it all.  If the primary doesn't pick up everything up, then I would think the doctor has to re-submit the non-paid portion to the seocndary insurance?

To answer your question, I would probably ask that BM make that call to the doctor office to get the bills paid.  If they don't get paid and say they go to collections, who's credit would it effect, that is something else to take into consideration. Becauuse if it was my credit, I would probably take the time to sort it out.

That's kind of my reasoning as well. BM is the account holder and is the one who takes SD to the doctor (we live 8 hours away and SD hasn't ever been sick at our house). It is her credit in jeopardy. I'm just afraid of the blame game that will ensue.

Actually, both of your DH & BM's credit is in jeopardy. A doctor's office does not have to follow a court order in regards to biling. They can legally go after either of the parents since they are both liable for their minor children. Regardless of whether or not BM should handle it, it is safer for you guys to make sure it's handled yourselves. With an insurance in your DH's name tied to the account, that also makes him liable in their eyes and they already have his information for them to ping his credit.

We actually had to deal with a collection in DH's name due to a bill BM did not pay, in regards to one of my SS's.

Krisx2

gin9874:

Krisx2:

bebe11:

I am not an expert in the insurance area, but I have 2 insruance coverages, one through my work (which is the primary) and one through my dh.  I give both insurance cards to the doctor (i really only had to do it once) and the doctor office or hospital should bill it all.  If the primary doesn't pick up everything up, then I would think the doctor has to re-submit the non-paid portion to the seocndary insurance?

To answer your question, I would probably ask that BM make that call to the doctor office to get the bills paid.  If they don't get paid and say they go to collections, who's credit would it effect, that is something else to take into consideration. Becauuse if it was my credit, I would probably take the time to sort it out.

That's kind of my reasoning as well. BM is the account holder and is the one who takes SD to the doctor (we live 8 hours away and SD hasn't ever been sick at our house). It is her credit in jeopardy. I'm just afraid of the blame game that will ensue.

Actually, both of your DH & BM's credit is in jeopardy. A doctor's office does not have to follow a court order in regards to biling. They can legally go after either of the parents since they are both liable for their minor children. Regardless of whether or not BM should handle it, it is safer for you guys to make sure it's handled yourselves. With an insurance in your DH's name tied to the account, that also makes him liable in their eyes and they already have his information for them to ping his credit.

We actually had to deal with a collection in DH's name due to a bill BM did not pay, in regards to one of my SS's.

Yikes! Sorry for your DH.

This isn't really applicable in our situation though. If the Dr. office (although I think BM used an insta-care because DH has faxed the pediatrician office his ins.) had DH's information, then his insurance would have already been billed. DH is also not listed as SD's parent on the account, BM's husband is (we have the account records from the last ER visit). So, as far as I've deduced, the billing office has no way of holding DH liable without processing it through his insurance first. And that responsibility lies upon BM, her insurance, and her Dr. office in my opinion.

Melzig76

holly71087:

I guess it depends what your CO says? is BM supposed to have primary insurance and DH supposed to hold secondary insurance? what about the remainder, who pays that?

Is the insurance through DH's employer? I personally would have DH handle it, especially since it seems BM is failing to hand in the proper paperwork/insurance info to the doctors office. 

 That's what I was thinking too..