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An unusual and entertaining medical billing problem


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I have two step-daughters and one of them is a sociopath (I will refer to her as 'Alice'. This is not her name.). My wife and I have custody of both girls starting in 2012 and they are covered under my insurance. We could no longer keep Alice under our care because she was threatening to kill my younger children. Alice's father took her, and a new custody document was drawn up: he takes custody of her, does not pay child support to my wife. We continue to cover Alice under my insurance, and her father is responsible for any medical bills beyond what insurance does not cover. Alice's father lives in another state.

 

Over the course of 2013 under the care of her father, Alice spent a great deal of time in 72 hour holds and multiple inpatient stays at psychiatric care facilities. She was taken away in an ambulance during this time due to feigning illness. Alice's father told us that he could no longer take care of her either...he sent her to live with other family members but this didn't work out either.

 

Alice is still covered under my insurance and now lives with her Grandparents in another state. She is still not doing well, but I think she will be able to stay with her Grandparents.

 

I am getting calls from "Medical Billing Offices" about debts that have gone unpaid during Alice's stay with her father in 2013. Alice's father told us that these bills are in the 10's of thousands of dollars and he simply cannot pay them. My wife and I did not agree to pay these medical bills. She was not under our care when these bills were accrued. Neither I nor my wife had any control over her medical care while she was with her father.

 

The medical billing offices are calling me (not my wife) because the insurance is under my name. Am I responsible for these bills? I have been told that these bills will soon go to collections. I cannot pay them.

 

So far the only action I have taken is to answer these phone calls and ask the medical billing offices to forward these communications in writing. I'm expecting a letter any day now.

Edited by syncracirca
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Check with your insurance Co. and get whatever documentation you can from them as to IF they had any of these bills sent to them, if anything was paid, if letters of refusal to pay were sent to the health care providers and if so, what the reasons were.

 

The fact that she MAY have been covered for some or all of these visits is the important thing to find out.

It is pointless to speculate as to the status of these claims for you to pay any bills unless you find out the exactly what occurred. It is obvious that your insurance was contacted in some way, otherwise you would not be getting contacted now.

 

In the meantime, opt out, and if you have moved try to get your old addresses deleted. Even if there is NO legitimate claim against you, the fact that you are being dunned will engender every scam scum JDB ( junk debt buyer) in the Country to come out from under the rocks and ding your reports.

http://www.whychat.5u.com/GUIDEBOOK.html

 

Once you find out exactly what has been going on, and once you check your REAL credit reports you can use some of the form letters in the HIPAA letter program, depending on what you may need.

 

http://www.whychat.5u.com/GUIDE%20HIPAA%20PROGRAM.html

 

You should also check with your lawyer to determine if the custody agreement is still in force, if you have any liability for her bills, or if she is eligible for some kind of State assistance.

 

Aside from trying to avoid paying these bills, you should also try to seek the best way to go forward in her medical care.

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I apologize if I seem cold and uncaring, and I agree that this child does need continued medical coverage and medical care. She is still on my insurance, but now has insurance through her grandparents that she lives with. I plan to drop her from my health insurance during the next open enrollment.

 

None of the contact I've had so far has been with any collection agencies, and so far my reports are clean. These debts are still being held by their respective healthcare organizations so far as I can tell.

 

My wife found her Amended Custody Decree. For the time frame in question it states that my wife and I were responsible for insurance coverage and that her father is responsible for 100% of what insurance does not cover. Would it be appropriate to send a copy of the Custody Decree to the billing office that called? They already had my address and I asked them to send me a letter for any further correspondence. Hopefully I haven't screwed up yet.

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No, you need to find out what, if anything was submitted to your insurance and what was paid.( if anything)

 

You should understand that a health care provider bills at X $$ but the insurance Co. pays a deeply discounted rate, a $10,000 bill submitted to insurance could have an approved amount of $1,200. If the providers had your insurance data, it means they were subject to agreeing to accept the discounted approved amounts.

 

In addition, depending on the time frames involved, the accounts may very well have been paid by your insurance and the medical billing offices are trying to get $$ they are not entitled to. How do you know that these "calls" are legitimate?? Have you called them back at a LISTED # for the health care providers?? Without a written request on a legitimate health care provider invoice you may find that you have been talking to some scam artist, and not the health care provider.

 

Besides, if they have been talking to YOU, and YOU are not a parent or legal guardian, they are in violation of the HIPAA privacy rules, so it is even more likely that this is a scam.

Edited by Why Chat
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I am her stepfather, but have no type of custody (never have) unless there is some state or federal law that gives me some form of custody by way of marriage to her mother that I'm not aware of.

 

I'm still waiting on a letter from the medical billing office that called. As you've advised I'm going to get any documentation I can. I do have a few paper statements from my insurance company showing what they have paid and what was not paid, but not all of them by any means.

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I am her stepfather, but have no type of custody (never have) unless there is some state or federal law that gives me some form of custody by way of marriage to her mother that I'm not aware of.

 

I'm still waiting on a letter from the medical billing office that called. As you've advised I'm going to get any documentation I can. I do have a few paper statements from my insurance company showing what they have paid and what was not paid, but not all of them by any means.

I believe you are being scammed. The HIPAA privacy rules would have prohibited any LEGITIMATE health care provider OR their collection agent from discussing her medical bills with you.

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I am her stepfather, but have no type of custody (never have) unless there is some state or federal law that gives me some form of custody by way of marriage to her mother that I'm not aware of.

 

I'm still waiting on a letter from the medical billing office that called. As you've advised I'm going to get any documentation I can. I do have a few paper statements from my insurance company showing what they have paid and what was not paid, but not all of them by any means.

Nope, you don't get custody of a child simply by marrying his or her parent. You'd have to get custody through the courts, or do a step parent adoption. I've also never heard of a step parent being legally liable for medical bills incurred by a stepchild (I have several step nieces and nephews in my family, so it's something I'm familiar with).

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I am her stepfather, but have no type of custody (never have) unless there is some state or federal law that gives me some form of custody by way of marriage to her mother that I'm not aware of.

 

I'm still waiting on a letter from the medical billing office that called. As you've advised I'm going to get any documentation I can. I do have a few paper statements from my insurance company showing what they have paid and what was not paid, but not all of them by any means.

Nope, you don't get custody of a child simply by marrying his or her parent. You'd have to get custody through the courts, or do a step parent adoption. I've also never heard of a step parent being legally liable for medical bills incurred by a stepchild (I have several step nieces and nephews in my family, so it's something I'm familiar with).

+1000. I know this for a fact!

 

 

Sent from my SCH-I535 using Tapatalk

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  • 5 weeks later...

I finally received the statement. It arrived in an envelope with the letterhead of a hospital in Louisiana. It looks like an invoice to my untrained eye, but it's not a medical bill. At the bottom it says:

 

02/11/14 STMT COLL EVT #1 SEQ #4 PRINTED

 

below that it says:

OTH.1 0.00

SP 50.00

 

It looks like they are saying I owe them $50. At the top of the letter it says "Guar <my social security number>". I take it this means I'm the "guarantor"?

 

$50 is not much money, but I'm afraid that if I pay it then it would be an admission to owing the money...which could mean they could send me MORE bills. I'm also afraid they will send it to a collection agency.

 

I've been getting more phone calls that I have missed, but when I look the phone number up on google it is medical billing collection agencies. At least 3 different agencies. For right now my credit reports are squeaky clean.

 

I'm not sure at this point if I should proceed with the HIPAA letter program, ignore them, or send them my wife's divorce decree/custody agreement showing that my step-daughter's father is responsible for any medical bills beyond what insurance did not cover.

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Pay the OC with the HIPAA letter insert "a"

http://www.whychat.5u.com/hipltr.html

Make sure you state you are doing it as a courtesy although you are not liable for the charge.

 

I don't know how long you will be maintaining her on your insurance but I urge you to contact your insurance Co and require them to send the EOMBs to your address as this will likely reoccur unless you take steps to either remove her from your insurance or get copies of ALL health care facilities she has gone to and advise them that co-pays and deductibles are NOT your responsibility and that you require them to obtain payment in advance for co-pays or deductibles. Send your insurance Co. a copy of each notice and tell them that unless the $$ are collected in advance that you request that the insurance Co.refuse the claim.

 

Inform your X about what you have done

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  • 1 month later...

OC paid, still pending a reply. No collections reporting. My HR dept where I work will not let me drop coverage on her without proof of new coverage. Her guardians refused to provide this to me, and they are actively using the insurance. I asked the Insurance Co. to send her patient profile for the past year. She was just in the hospital again this April.

 

The Custody Decree says they are to seek insurance for her 'if available'. I'm having trouble interpreting the patient profile, but it looks like there was about 15k owed in 'coinsurance' and 'copays'. Total amount billed was appx 46k.

 

I'm going to begin following your other instructions from the last post.

 

 

 

unless the $$ are collected in advance that you request that the insurance Co.refuse the claim.

 

Can I ask the insurance to do this retroactively, or would it only apply to future claims?

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