Expert: Regan Shinski - 9/18/2009

Question
QUESTION: My husbands ex took their daughter to a psychotherapists for the past 4 months without any payment.  My husband gave his insurance info to the office and asked to be notified if any portion was not covered.  Now we get a bill for $900 because there was a $50 coinsurance bill for every session.  We did not ok this.  I talked to the biller and she was absolutely no help.  I asked them why they would see a patient with no payment or insurance info for 4 months.  She said they do it on good faith.  Ive never heard of a dr doing that.  I think my husbands ex mustve told them we will pay or something ridiculous.  Do we have to pay this?  We did not authorize it and were never billed until she had already gone to 15 sessions.  What can we do?



ANSWER: Hi Laura:

There are a couple factors at play here.  The first is to confirm what is in the divorce decree.  Most have some provision outlining how the medical care for the children is treated.  A few even outline an approval process for selecting doctors in non-emergency situations.  Above all else in cases like this, that document carries the most weight.  If you feel these medical charges were made outside the scope of responsibility for your husband, you need to show that to the medical office.  They cannot bill your husband if that is clearly outlined.  They also cannot report to your husband's credit, charges your husband's ex is responsible for but has not paid.  Similarly, if you are being billed for 100% and you should only be responsible for - say - 50% of the medical bills, you need to show the docs to the medical office.  Again, in that case, you guys would be responsible for half and the office cannot try and collect (including reporting to credit bureaus) the other half your husband's ex has not paid.

The second issue is "are the medical services needed?"  I can tell you this will be an uphill battle except in extreme situations.  Courts have adjudicated that the custodial parent has great latitude in seeking medical care for their children.  So unless it is obviously frivolous treatment, it will be tough to prove.  There are options to ask the court to make a decision if the treatments were medically necessary.  If the court deems them responsible treatment, your husband would be responsible for his share (as outlined in docs) of the bills.

On the issue of four months of treatments, I do not believe you have an argument.  They provided the services and it's not like they carried on for twenty years to run up the bill.  Four months is basically 90 days late on a net-30 billing.  That is a fairly common billing cycle.  I don't think it would be deemed excessive.

Good luck, comb through the divorce papers, it's the key point in to your question.

Regan

---------- FOLLOW-UP ----------

QUESTION: Regan, what if there are no divorce papers?  They were never married.  My husband still has full custody but has allowed her to live with her mother the past year.  But we never wouldve agreed to send her to this dr if we knew it'd be $50 each visit and she was going every week.  The billing person he spoke with was to advise him of any charges that werent covered and she never did.  Now the bill has racked up to $900.  How can we be expected to pay that when we never authorized it?

ANSWER: Hi Laura:

Is there any court order of custody outlining medical care?  Child support documents?  If so, those documents take precedence.  I'm afraid you may not like my answer, but I think it reverts to "second issue" as I wrote in my first reply.  ESPECIALLY if you husband has full custody.  In fact, I think he may be responsible for 100% in most states as the the full custodial parent.  What the court would see is a full custodial parent who GAVE custody to another.  I mean "GAVE" as in parental decisions, not that he doesn't care or love his child - speaking only on the day-to-day decisions, not making a moral statement.  It is further hurts that he gave the insurance information to the medical office as that shows knowledge and tacit approval of the visits.

This can vary by state, and I urge you to research further, it is not my primary area of expertise but I am fairly confident.

So, if that is the case, you still have some options:

*  You have mentioned twice about telling the office to contact you if any charges are not covered.  You potentially have a verbal contract with the office to limit your exposure.  Difficult to prove, but possible.  

*  In some states, medical offices basically have to provide an estimate for non-emergency treatment.  Much like an auto repair shop can't just complete work without an estimate, these laws tell medical offices they cannot rack up bills without telling the patient their costs.  The problem is it's "only" (I know it's still a lot) $900 and 4 months.  It's not thousands of dollars and years of treatments.   

*  Have you tried to negotiate the amount down?  It's a tough economy, there are mitigating circumstances, you may get a favorable option.

*  There are credit repair options to fix your husband's credit after-the-fact.  Contact me again if this is an option for you.  Negative credit items CAN be removed, it's my primary area of expertise.

Again, I mentioned the "second option" above regarding my first reply.  Basically you would have to prove the medical care was frivolous, excessive, or otherwise not needed.  It's a difficult argument because courts generally allow "reasonable" care for children.  It's complicated by the what I said above: that a court may view your husband as having "gave" the decision making to his mother and now he would be arguing against the decisions she made.  (Again, not saying anything personal, just how a court could look at it.)

I wish I had better news or options for you!  I'm just not very optimistic about your chances, especially as the full custodial parent.

Good luck.  Seek another opinion.  These issues vary by state so there may be other options.
Regan

---------- FOLLOW-UP ----------

QUESTION: Thank you for your help. Fortunately the daughter just turned 18 and we shouldnt have to deal with this kind of BS any longer.  I know they were getting bills for this and never telling us.  What a pain.  
Thanks again.

Answer
You're welcome.  At the very least, if the medical office was sending statements to her mother's address when you husband clearly gave them insurance information with HIS address and now they are trying to collect from HIM, you should use that to keep any collections off his credit reports.  I think you could also use that to try and negotiate a reduced amount.