Ex abusing via medical billing
June 21, 2014 12:15 PM Subscribe
My friend is divorced, ex has custody of the 2 children. Ex is a sociopath who has made screwing up my friend's life one of his main hobbies. Their divorce decree has uncovered medical expenses split 50/50. While this may seem like a usual, reasonable thing, especially since the ex is in the military with very good health insurance and doctors at his large army base, he is starting to use it against her.
He has started taking the children to out of network dentists and doctors and billing her for the 50% portion. He is not telling her any information, such as the doctor's names or what type of surgery is scheduled.
It is obvious that he is doing this in order to generate expenses that my friend does not have the resources to pay, so that he can bring a contempt motion against her.
Even if insurance eventually sends him a check to cover some of the expenses, he will not give my friend her portion of the refund. So he can actually make a profit from this.
When the ex brings a contempt motion against my friend for failure to pay, what can my friend do so that she doesn't get screwed over in court? She has no financial resources at all, and chances are she will be pro-se.
If he does get reimbursed from the insurance company, how can she prove it? During the divorce he did lie about reimbursements that he cashed, and he got away with it.
He has started taking the children to out of network dentists and doctors and billing her for the 50% portion. He is not telling her any information, such as the doctor's names or what type of surgery is scheduled.
It is obvious that he is doing this in order to generate expenses that my friend does not have the resources to pay, so that he can bring a contempt motion against her.
Even if insurance eventually sends him a check to cover some of the expenses, he will not give my friend her portion of the refund. So he can actually make a profit from this.
When the ex brings a contempt motion against my friend for failure to pay, what can my friend do so that she doesn't get screwed over in court? She has no financial resources at all, and chances are she will be pro-se.
If he does get reimbursed from the insurance company, how can she prove it? During the divorce he did lie about reimbursements that he cashed, and he got away with it.
He has started taking the children to out of network dentists and doctors and billing her for the 50% portion. He is not telling her any information, such as the doctor's names or what type of surgery is scheduled.
I feel like something is missing here.
How does he 'bill her' without providing information such as the doctor's name, or the procedure? There should be basic info on any medical receipt. And if the friend doesn't know the names of the doctors, how does she know they are "out of network" or that the insurance is providing refunds?
Also, surgery? Even parent without custody would have some rights regarding consent. Usually. There might be some (major) mitigating factors here.
posted by kanewai at 1:01 PM on June 21, 2014 [15 favorites]
I feel like something is missing here.
How does he 'bill her' without providing information such as the doctor's name, or the procedure? There should be basic info on any medical receipt. And if the friend doesn't know the names of the doctors, how does she know they are "out of network" or that the insurance is providing refunds?
Also, surgery? Even parent without custody would have some rights regarding consent. Usually. There might be some (major) mitigating factors here.
posted by kanewai at 1:01 PM on June 21, 2014 [15 favorites]
Is he giving her any kind of PROOF that these bills were ever even honestly incurred --- copies of the doctor's reports, copies of ANYTHING? Or is he merely telling her "you owe $X"?
Sorry, but she needs to call her lawyer: she needs professional help, right now.
posted by easily confused at 1:11 PM on June 21, 2014 [7 favorites]
Sorry, but she needs to call her lawyer: she needs professional help, right now.
posted by easily confused at 1:11 PM on June 21, 2014 [7 favorites]
Lawyer.
posted by k8t at 1:24 PM on June 21, 2014 [11 favorites]
posted by k8t at 1:24 PM on June 21, 2014 [11 favorites]
She has to go to his CO - there is an office specifically for facilitating precisely these issues.
Today, Monday at the latest if she can't get a hold of someone on the weekend.
posted by Lyn Never at 1:27 PM on June 21, 2014 [16 favorites]
Today, Monday at the latest if she can't get a hold of someone on the weekend.
posted by Lyn Never at 1:27 PM on June 21, 2014 [16 favorites]
Two things, CO and lawyer.
This is nothing you try to do Pro Se.
posted by Ruthless Bunny at 2:17 PM on June 21, 2014 [4 favorites]
This is nothing you try to do Pro Se.
posted by Ruthless Bunny at 2:17 PM on June 21, 2014 [4 favorites]
Also, your friend needs to stop rolling over for this yutz. She's not a victim. Is it work? Yes. Does it suck. Yes. But she needs to challenge him every step of the way, because he'll keep hassling her if she doesn't and it won't get better, it will only get worse.
So, SHE needs to drag HIM into court and make HIS life a hassle for a change.
posted by Ruthless Bunny at 2:33 PM on June 21, 2014 [1 favorite]
So, SHE needs to drag HIM into court and make HIS life a hassle for a change.
posted by Ruthless Bunny at 2:33 PM on June 21, 2014 [1 favorite]
Response by poster: I don't want to threadsit, so I'll just try to clarify a few things and hope for ermm, some hope.
Yes, there is a lot missing here, but saying too much might identify her.
She does NOT have resources to get another lawyer. Really. She has one now who is wrapping up issues from the last hearing (her contempt motion against him for not complying with the decree), but is expected to drop her as a client, since there is no mechanism for him to be paid.
The ex does have final medical decision authority, so her consent is not needed.
The decree gives her responsibility for payment, but does not define requirements for him to provide anything such as receipts or medical records. A reasonable person would provide it, but his goal is to inflict psychological and financial harm.
In the past his CO and others in the military were contacted for more clear cut violations, such as lack of child support, and nothing happened.
What we're looking for are specific tips for how she should respond when he sends a request for payment, besides asking for receipts/records (which, again, he isn't required to give her).
What can she say to put herself in a better position when she is in front of a judge?
posted by anon4now at 2:56 PM on June 21, 2014 [1 favorite]
Yes, there is a lot missing here, but saying too much might identify her.
She does NOT have resources to get another lawyer. Really. She has one now who is wrapping up issues from the last hearing (her contempt motion against him for not complying with the decree), but is expected to drop her as a client, since there is no mechanism for him to be paid.
The ex does have final medical decision authority, so her consent is not needed.
The decree gives her responsibility for payment, but does not define requirements for him to provide anything such as receipts or medical records. A reasonable person would provide it, but his goal is to inflict psychological and financial harm.
In the past his CO and others in the military were contacted for more clear cut violations, such as lack of child support, and nothing happened.
What we're looking for are specific tips for how she should respond when he sends a request for payment, besides asking for receipts/records (which, again, he isn't required to give her).
What can she say to put herself in a better position when she is in front of a judge?
posted by anon4now at 2:56 PM on June 21, 2014 [1 favorite]
She needs a lawyer, and she can get one free. Here's a site to start finding someone.
I would also suggest that your friend start learning to write her own motions, and to become her own legal experts. There is so much good information out there now, women's advocacy groups can be of help too.
You can always have the decree and child custody arrangement amended, so she should head to court to codify and clarify the decree. It's not unreasonable to ask for this. She can file her own brief if she needs to. Here's a site in CA, you can google for your location.
Don't wait to be in contempt, nip it in the bud before it happens any more.
Again, stop being a victim, be an advocate for your own rights.
posted by Ruthless Bunny at 3:27 PM on June 21, 2014 [16 favorites]
I would also suggest that your friend start learning to write her own motions, and to become her own legal experts. There is so much good information out there now, women's advocacy groups can be of help too.
You can always have the decree and child custody arrangement amended, so she should head to court to codify and clarify the decree. It's not unreasonable to ask for this. She can file her own brief if she needs to. Here's a site in CA, you can google for your location.
Don't wait to be in contempt, nip it in the bud before it happens any more.
Again, stop being a victim, be an advocate for your own rights.
posted by Ruthless Bunny at 3:27 PM on June 21, 2014 [16 favorites]
Call military one source. They were a great help during my divorce.
posted by spunweb at 4:07 PM on June 21, 2014 [3 favorites]
posted by spunweb at 4:07 PM on June 21, 2014 [3 favorites]
She does not need to pay for things without proof. It may not be in the wording of the agreement, but I bet it doesn't say roll over and pay whatever he says based only on his word either. Ask for receipts or copies of bills. Remember if he actually is taking the kids to doctors etc for unnecessary medical procedures and treatments just to get at her, that is a form of child abuse.
It's hard to stand up to sociopaths/narcissists that want to "punish" you, I have watched my SIL trying to fight off the continued efforts of my brother to punish her. Luckily in her case she's the one with money so it's easier for her to just lawyer up and let them do the hard work of pushing back. Your friend needs to find some support groups to help her, either online or locally, to help her find the strength to stand up for herself. He will not stop until she stops making it easy for him. I know how hard it is, I have seen the end results of a person broken down by people like this so I don't say that lightly, but she really needs to focus on making herself strong enough to do this. It took my SIL almost 18 months and a lot of therapy after the divorce to finally start standing her ground against my brother and it is slowly starting to make a difference.
Give your friend a hug from me, because if she's been through even part of what my SIL has and is still standing she has nothing but my respect.
posted by wwax at 4:12 PM on June 21, 2014 [4 favorites]
It's hard to stand up to sociopaths/narcissists that want to "punish" you, I have watched my SIL trying to fight off the continued efforts of my brother to punish her. Luckily in her case she's the one with money so it's easier for her to just lawyer up and let them do the hard work of pushing back. Your friend needs to find some support groups to help her, either online or locally, to help her find the strength to stand up for herself. He will not stop until she stops making it easy for him. I know how hard it is, I have seen the end results of a person broken down by people like this so I don't say that lightly, but she really needs to focus on making herself strong enough to do this. It took my SIL almost 18 months and a lot of therapy after the divorce to finally start standing her ground against my brother and it is slowly starting to make a difference.
Give your friend a hug from me, because if she's been through even part of what my SIL has and is still standing she has nothing but my respect.
posted by wwax at 4:12 PM on June 21, 2014 [4 favorites]
besides asking for receipts/records (which, again, he isn't required to give her).
Well, no. Just because he says he isn't required to give them to her doesn't make it so. And just because the divorce decree doesn't say he has to provide copies of bills doesn't make it so. She is required to pay 50% of the bills, not 50% of any number he pulls out of his ass. 50% of a bill requires a bill, end of debate.
She needs to send him an email that says "You have sent me invoices for X, Y and Z dates. Please provide copies of the bills in question, and note that moving forward, you will need to provide copies of any medical bills for which you are seeking reimbursement under the terms of our divorce decree."
And she just needs to keep repeating that, rather than debating it. What she says to the judge is that her ex is refusing to provide copies of the bills for which he is seeking 50% reimbursement.
posted by DarlingBri at 4:35 PM on June 21, 2014 [30 favorites]
Well, no. Just because he says he isn't required to give them to her doesn't make it so. And just because the divorce decree doesn't say he has to provide copies of bills doesn't make it so. She is required to pay 50% of the bills, not 50% of any number he pulls out of his ass. 50% of a bill requires a bill, end of debate.
She needs to send him an email that says "You have sent me invoices for X, Y and Z dates. Please provide copies of the bills in question, and note that moving forward, you will need to provide copies of any medical bills for which you are seeking reimbursement under the terms of our divorce decree."
And she just needs to keep repeating that, rather than debating it. What she says to the judge is that her ex is refusing to provide copies of the bills for which he is seeking 50% reimbursement.
posted by DarlingBri at 4:35 PM on June 21, 2014 [30 favorites]
Is there a local domestic violence resource center she can contact? A lawyer might be the ideal resource in this situation, but DV organizations are generally free of charge and have lots of experience navigating situations like this--hopefully they can help her figure out a plan that may even include getting back into court to address this situation head-on.
posted by epj at 4:41 PM on June 21, 2014
posted by epj at 4:41 PM on June 21, 2014
Well, no. Just because he says he isn't required to give them to her doesn't make it so.
To be clear - my custody order included language that she could have access to his records. However, it didn't dictate that I had to give them to her - She would have to get them herself. And, not to be snarky - this is better. If she gets them herself, from the doctors/schools/whatever, then she has gotten all of the records and knows I haven't forgotten/excluded some portion. If she doesn't do this, then how involved is she as a parent, really ?
Also, it is entirely possible he's got good reasons for taking the kid to out of network doctors - maybe the ones on the base suck, or whatever. The costs for these things is the sort of thing they should be sorting out themselves and relying on the court order if that fails. It will come up again when the kid wants to go to summer camp, or piano lessons, or what-have-you.
My advice - hire a lawyer and get it sorted out.
posted by Pogo_Fuzzybutt at 8:06 PM on June 21, 2014 [1 favorite]
To be clear - my custody order included language that she could have access to his records. However, it didn't dictate that I had to give them to her - She would have to get them herself. And, not to be snarky - this is better. If she gets them herself, from the doctors/schools/whatever, then she has gotten all of the records and knows I haven't forgotten/excluded some portion. If she doesn't do this, then how involved is she as a parent, really ?
Also, it is entirely possible he's got good reasons for taking the kid to out of network doctors - maybe the ones on the base suck, or whatever. The costs for these things is the sort of thing they should be sorting out themselves and relying on the court order if that fails. It will come up again when the kid wants to go to summer camp, or piano lessons, or what-have-you.
My advice - hire a lawyer and get it sorted out.
posted by Pogo_Fuzzybutt at 8:06 PM on June 21, 2014 [1 favorite]
The best thing you can do to help your friend is to find her competent legal counsel. That needs to be your number one priority. Full stop. I know it's incredibly difficult to find pro bono help, but you need to exhaust every possible solution. Some places to call include your local bar association, law school clinics, domestic violence organizations. If they say they can't help you, ask them to refer you to someone who can.
This situation is completely out of control and the longer you try to manage it on your own, the worse it will become.
Some other thoughts (which are not legal advice): Like everyone else in the thread has mentioned, your friend needs the receipts and records of what services have been rendered before she pays anything. The ex is taking the kids in for *surgery* and there's no paper trail? This doesn't add up. Do you have emails, letters, or voicemail from him talking about these medical procedures? Does your friend have a paper trail that shows her asking for the receipts? Does your friend have a paper trail of him refusing to provide documentation?
Do you have a record of how much money has been given to the ex for medical bills? Do you know the specific service the money was supposed to go towards (cavity filling, vaccination, etc) or did your friend hand over money without knowing?
Even if you get receipts, you need to follow up with the doctors to make sure the kids actually went to that office.
Has your friend tried contacting her kid's school to request copies of any health records the school has? Maybe you can get a doctor's name from those records and follow up with them. Have you tried contacting the insurance directly and asking for records of what has been submitted for the kids?
This situation is baffling and it really does feel like we're missing some big pieces that are essential to understanding it correctly. Please, please look for pro bono legal help. Do not stop until you find it.
posted by helloimjohnnycash at 9:04 PM on June 21, 2014 [4 favorites]
This situation is completely out of control and the longer you try to manage it on your own, the worse it will become.
Some other thoughts (which are not legal advice): Like everyone else in the thread has mentioned, your friend needs the receipts and records of what services have been rendered before she pays anything. The ex is taking the kids in for *surgery* and there's no paper trail? This doesn't add up. Do you have emails, letters, or voicemail from him talking about these medical procedures? Does your friend have a paper trail that shows her asking for the receipts? Does your friend have a paper trail of him refusing to provide documentation?
Do you have a record of how much money has been given to the ex for medical bills? Do you know the specific service the money was supposed to go towards (cavity filling, vaccination, etc) or did your friend hand over money without knowing?
Even if you get receipts, you need to follow up with the doctors to make sure the kids actually went to that office.
Has your friend tried contacting her kid's school to request copies of any health records the school has? Maybe you can get a doctor's name from those records and follow up with them. Have you tried contacting the insurance directly and asking for records of what has been submitted for the kids?
This situation is baffling and it really does feel like we're missing some big pieces that are essential to understanding it correctly. Please, please look for pro bono legal help. Do not stop until you find it.
posted by helloimjohnnycash at 9:04 PM on June 21, 2014 [4 favorites]
If the CO wasn't helpful, contact /his/ CO and mention that the previous CO was not helpful. The chain of command tends to follow the following structure - company, battalion, brigade. Approaching the Battalion command when company has failed generally reaps a hurricane. Continue up the chain as needed. It's a pain in the ass but brings a world of hurt.
Really, I don't know that you'll be able to prove this in front of a court, there's no law about someone going to more expensive doctors.
I think she's letting him freak her out. Yes, she has responsibility for payments, but not for anything he doesn't have proof of expenses. Trust me, I've been divorced, you need proof in order to be billed. Otherwise he could just say "I spend 2K on medical, give me 1K."
posted by corb at 9:57 AM on June 22, 2014 [6 favorites]
Really, I don't know that you'll be able to prove this in front of a court, there's no law about someone going to more expensive doctors.
I think she's letting him freak her out. Yes, she has responsibility for payments, but not for anything he doesn't have proof of expenses. Trust me, I've been divorced, you need proof in order to be billed. Otherwise he could just say "I spend 2K on medical, give me 1K."
posted by corb at 9:57 AM on June 22, 2014 [6 favorites]
IANAL She should be polite and civil, and communicate with him calmly, requesting documentation. She should make reasonable efforts to pay for her childrens' health care, even if he is being a jerk. This may mean that she pays what she can on a monthly basis. He can cite her for non-payment, but if she has low wages, there won't be much if anything to garnish. She should keep records of the medical bills.
Meanwhile, if he's being a big jerk, and they're at war, it's probably getting to the kids. She should make every effort to maintain a healthy relationship with them, and not discuss her ex. She can ask them about their health, showing concern, and can keep records if they say anything about getting care that isn't appropriate, but she shouldn't drag them into any debate. From my experience, family courts favor the parent who is most reasonable.
posted by theora55 at 11:52 AM on June 22, 2014 [1 favorite]
Meanwhile, if he's being a big jerk, and they're at war, it's probably getting to the kids. She should make every effort to maintain a healthy relationship with them, and not discuss her ex. She can ask them about their health, showing concern, and can keep records if they say anything about getting care that isn't appropriate, but she shouldn't drag them into any debate. From my experience, family courts favor the parent who is most reasonable.
posted by theora55 at 11:52 AM on June 22, 2014 [1 favorite]
She does NOT have resources to get another lawyer. Really.
Was she married to him long enough as a military wife to still qualify for a military ID? If so, she may have access to free counsel on base.
Also, yes, write to his commanding officer. My ex has a lot of traits of a sociopath and I knew I could trust him when we filed our divorce ourselves because he was career military and was not about to cut his own throat to screw me over. He knew that I knew that if he screwed me, I could go after him through the military and he basically could not escape. If the military decides to garnish your pay, the garnishment comes out first, at the start of the month, and whatever is left gets divided up between your two paychecks. That can leave you not enough to pay rent on the first, if it is ugly. The military does not play.
Third, contact the insurance company. If he is getting funds from her and not remitting to the insurance company, this could be deemed insurance fraud. If proven, it could land his ass in jail. The insurance company likely has its own investigators in house and will do the investigation to cover their own interests, at no expense to her. Because once people get started on insurance fraud, it tends to get worse. They start referring to the company as "The ATM" and they just want more and more once they figure out how to get a few extra bucks out of them, so those folks take this shit seriously
Contact the state insurance commissioner. They may be able to help her figure out how to address the insurance piece of it and there should be no charge. They are there as a consumer advocate, a service for the people.
posted by Michele in California at 1:40 PM on June 22, 2014 [7 favorites]
Was she married to him long enough as a military wife to still qualify for a military ID? If so, she may have access to free counsel on base.
Also, yes, write to his commanding officer. My ex has a lot of traits of a sociopath and I knew I could trust him when we filed our divorce ourselves because he was career military and was not about to cut his own throat to screw me over. He knew that I knew that if he screwed me, I could go after him through the military and he basically could not escape. If the military decides to garnish your pay, the garnishment comes out first, at the start of the month, and whatever is left gets divided up between your two paychecks. That can leave you not enough to pay rent on the first, if it is ugly. The military does not play.
Third, contact the insurance company. If he is getting funds from her and not remitting to the insurance company, this could be deemed insurance fraud. If proven, it could land his ass in jail. The insurance company likely has its own investigators in house and will do the investigation to cover their own interests, at no expense to her. Because once people get started on insurance fraud, it tends to get worse. They start referring to the company as "The ATM" and they just want more and more once they figure out how to get a few extra bucks out of them, so those folks take this shit seriously
Contact the state insurance commissioner. They may be able to help her figure out how to address the insurance piece of it and there should be no charge. They are there as a consumer advocate, a service for the people.
posted by Michele in California at 1:40 PM on June 22, 2014 [7 favorites]
This thread is closed to new comments.
Involve his commander. MeMail me if you want specifics.
posted by Etrigan at 12:25 PM on June 21, 2014 [53 favorites]