Time limits on medical bills (long)

Ginlyn0

If a CO says that a party incurring charges has 30 days to submit a bill to the other parent and then that parent has 30 days to pay their half to either the other party or the hospital/doctor, what happens if the party incurring the charges does not submit the bill then months later? Is it then their responsibility?

What if there were also a court date between the time the bill was incurred and at court all CS and medical support arrearages were forgiven and then a party submits a bill?

IMO, if I don't submit bills to my ex by the deadline, he's not obligated to pay. I actually don't send him most bills because they are typically small copays and I only typically send him larger ones that I need help with, but I make sure to send them by the deadline.

When DH lost his job last Dec, the kids lost coverage. BM was supposed to apply for state kids insurance (like we did for DS) but she did not because she couldn't prove her DH's income so it was too difficult (her words). The only reason the kids were not added to my policy originally when DH lost his job is because my family deductible is $10,000 and we knew that they needed better coverage which is why we asked her to get them on the state insurance plan. So she took out a private policy and never provided us with a copy of the policy or gave us any coverage details just said she had taken care of it, but we do have the insurance card which does not say copay/deduct amounts. The CO states we are to be given a copy of the policy by BM within 30 days. So in April SS2 busted his head open and had and ER visit on BM's time. Then in July, SS1 a several day hospital admit, plus surgery, plus 2 ambulance rides (from hospital to surgery center back to hospital).

So their court papers from this September basically state that as of a certain day in September, DH has $0 arrears for CS and $0 arrears for medical support following BM's releasing him of the arrears. BM never submitted these bills to us previously and did not submit the to the court that day. We now pay for the kids coverage on BM's policy. It's at this point while at court that DH found out her policy has a $25,000 deductibe. DH asked if we could add them to my policy at this time and knew I couldn't add them til open enrollment without a CO and the court said they could not order it since I'm not a party to the CO so we were told to wait until my next open enrollment and we could add them and then have BM sign paperwork to adjust the CO so that DH isn't paying her extra to cover the kids on her policy.

So Friday, she hands DH like 5 bills that include SS2's ER visit from April, and multiple provider/hospital bills from SS1's surgery. They are "current" dated bills but they are also just the bills the providers re-send when they want you to pay and some were not itemized (our CO says they submitted bills must be itemized) and the April bill for example shows where she made a payment previously in April so it's obvious she had gotten these bills before. She didn't give us copies of the EOBs either....

So my question is do you think according the given info, we are required to pay in 30 days, pay at all? We can't pay in 30 days for sure. One bill for SS1 was over $11,000 alone. I do have an accident policy at work that is free to me (all the kids are on) that I could have claimed the bill for SS2's ER visit for because it was a bodily injury but BM didn't give us the paperwork timely enough to claim on that.

We won't be paying these bills anytime soon with DH now without a job, but is there any reprecussion for her for not submitting the bills? Does that mean they are her responsibility now, technically? Of course I would help pay, if we could, but we can't right now. But I can't for the life of me figure out why she would take out a $25,000 deductible policy on the kids especially when SS1 has ongoing kidney issues and has had multiple procedures...I will definitely be adding them to my policy when open enrollment occurs $10,000 is better than $25,000....

CFjo2010

My opinion is no, your husband is not responsibile for these bills.  If the invoices (not services rendered) are dated prior to September, then BM assumed responsibility for the bills.  You may want to try and determine when the first round of invoices were mailed to BM.  I'm going to assume they were mailed prior to September and as you indicated, she began making payments here and there but failed to provide you the invoices.  Check with an attorney.  I would think BM's failure to mitigate her damages (failure to put the kids on health insurance as previously agreed upon) would relieve your husband of paying these astronomical bills.  But again, check with an attorney.

twister22

Based on everything you stated, I would think that you are not responsible for these bills, seeing as BM did not get the original bill to you within 30 days.

new+tothis

I agree - they're not your responsibility. I'm a BM and I think this is super sketchy. Why the heck would anyone put kids on a $25,000 deductible? I had to put DS on state insurance for a short while. I'm not going to lie. It was a PITA. It was also totally worth it. If she got the bills more than 30 days ago I say they are not your responsibility (especially given her weirdness with not getting them good insurance and your Sept. court date).

fellesferie

In terms of technical legal responsibility, I guess you're probably off the hook.

But I think he has an ethical responsibility to try and do something. They're still his kids, they were injured, and they were given care. 

Birdy2011

I don't think legally that you are obligated to pay for these bills.  BM did not give the invoices to you within the 30 day window, and your DH was absolved of arrears for medical bills in the September court date.  I think these are her bills to deal with at this point.

She had the opportunity to bring this up at the court date in September, and it seems that she made a choice not to do so.  She knew the had the bills to pay already since there has been payment on at least a portion of the bills prior to that court date. Something seems amiss there to me. 

I hope your open enrollment is soon so you can get the kids off of that $25,000 policy and onto your policy. I also hope that your DH is able to find a job quickly. 

Ooglybear

In DH's CO, if a medical bill is not submitted within 30 days, the other parent is still responsible for 50%, but they have 120 days to pay instead of 30. I really don't know how your courts normally handle this scenario though. Yikes, that's a lot of money...

Nineoceans

$11,000 after insurance?!? Jeez. I would let her take me to court over it, but also read your CO really carefully to make sure there is no loophole as a PP said about having more time to pay versus not having to pay at all. It's so weird she would just let these bills go. She is either really disorganized or trying to pull something. Either way she needs to call the billing dept of the hospital and try to work out a discount and payment plan, that is really an obscene amount and sounds like it's the amount before insurance not after (you know how you get a statement of service then later get one showing the modified amount ins. provided)

Phantomgirl

fellesferie:

In terms of technical legal responsibility, I guess you're probably off the hook.

But I think he has an ethical responsibility to try and do something. They're still his kids, they were injured, and they were given care. 

Whilst I generally agree with felles I am not so sure here.

The medical bills were forgiven in a court of law.  Anything prior to September 1st is now legally forgiven.

BM had the opportunity to present the bills for consideration and she choose not to.

I cannot fathom why she did that BUT she did and the consequences are that she now has to pay the bills.

I cannot see how she could argue that these do not fall under medical bills???

Had SHE presented the bills they would have been taken into consideration??

BUT I do have to ask - was your DH aware of them back in April?  I also cannot figure out how his kids received medical care and he thought there were no out of pockets???  He must have been anticipating something right?

If he did know about them then maybe I can see an argument for him contributing from a moral stand point.

In regards to how to proceed today, send her back the bills and a copy of the judgement stating that medical bills prior to Sept 1st have been forgiven.

 

 

 

FutureMrsWittig

I agree with Phantom, send her back the bills and a copy of the judgement. 

As far as morality is concerned, I would have your husband speak with her and let her know that he realizes these bills are huge and he would like to contribute toward them, he just can't pay them outright at this time, and he doesn't understand why she withheld them so long.  Maybe he can see if the two of them can work out a payment plan with the providers so they each pay a little per month?  Most of the time hospitals are willing to work with you to pay off bills over time as long as you pay regularly.

Ginlyn0

To clarify some, yes we knew there would be some out of pocket, however we were never given the copy of BM's policy that says she has a $25,000 deductible so we would have never anticipated an $11,000+ bill. Possibly $2500 to $5000 which would make our half $1250 to $2500 which would not have been a problem before DH lost his job last week. I guess DH assumed that since she never gave us a bill she had taken care of it which is what she has done in the past when she did not give us copies. We were under the impression the kids had decent coverage.

We cannot pay anything right now with DH not having a job just as we could not pay any if it were my DD or our DS. So this isn't about treating them any differently. However, I was concerned about legal ramifications in regards to the CO.

DD is on her SM's policy currently which has no deductible and very low copays (dream insurance) and DS is on state insurance which she had previously said she would also put the kids on but did not. Our copays for ER is $75 and for inpatient admission its is $125 per admission we have a cap of $2500 out of pocket (which applies to whole family) but only DS is on it. So had she done the same for the kids, she would have similar or lower copays because we are at the max cap and from what I understand her DH makes less money than we do. In reality, if the state would have allowed us to apply for state insurance for them this wouldn't have been a problem but since they don't live with us we cannot. And this is one way having a blended family sucks, BM chose a $25,000 because she knows nothing about insurance and we have to live with the financial reprecussions where as if they lived with us, we would not have these crazy bills.

fellesferie

If you cannot pay, then you cannot pay. Given what you posted, I think there is literally nothing you give them at the moment. 

I've been thinking about this a bit, and I think there are a few variables at play. 

- My CO obligates me to notify XH of any medical bills within 30 days, and it requires him to remit payment to me within 30 days of notification. I have never one time read it thinking that if I did not notify him within 30 days, it absolved him from all financial responsibility. Your situation is obviously different as you've been to court recently, but I'm just sharing my interpretation.

- I do not always receive hospital bills within 30 days. When I had DD in Jan 2010, we did not get a bill until March. When DS had outpatient surgery last April, we did not get a bill until the beginning of June. When my aunt died in the hospital, my parents did not get a bill for over six months. 

- I'm not sure that not knowing about the insurance plan is a factor. I think what she did sucks (a lot), but I think that YH had a responsibility (and a right!) to find out about the plan. Especially with having had a court date between now and then.

- I understand that BM effectively absolved YH of all responsibility. I think that this is a factor that should be taken into consideration. I think that I'd be really concerned about her naivete or absence of common sense in how she's approached the situation. I also think you should take steps to protect yourselves and the kids from that in the future.  

- But I think that the bottom line is that the hospital is owed money. The professionals that work there (theoretically) provided the children with good care when they needed it. And you rely on the fact that they will in the future. They deserve to be paid for that. And unless BM is sitting on a pile of money and could easily pay on her own, I think YH an ethical responsibility to help if and when he can. 

I am biased for two reasons: one, my mom is a nurse practitioner who worked at a big hospital for over 30 years; and two, I spent a couple years as a healthcare writer working with different hospitals and know how much many of them are struggling financially. 

Ginlyn0

It's 30 days from when she recieves the bill not the date of service, BTW. That is specified in both my CO and DH's the same way. So we never would expect 30 days from service but trust me I know all about insurance. I work for a health insurance company.

And Felles in regards to "I'm not sure that not knowing about the insurance plan is a factor. I think what she did sucks (a lot), but I think that YH had a responsibility (and a right!) to find out about the plan. Especially with having had a court date between now and then."

She is legally obligated to give us a copy of the policy within 30 days per the CO. She didn't. Typically insurance companies will not discuss anything about the policy with someone not the policyholder. Again, I work in insurance as well as when DH was covering DD on his policy and there was a problem with payment on a bill they refused to talk to me because I wasn't the policyholder even though I was the spouse and the LEGAL parent of the child. My company also will not discuss policy details with anyone except the policyholder. That's because most insurance companies are too chicken to mess with breaking a HIPAA regulation.

Karma1969

Too messy.  Leave it up to the court to figure out.