Month: December 2004

From Jan. 2 to Dec. 4, 2004, All letters (7) to Anthony were pertaining to uncovered medical expenses that he is refusing to pay reminding him what the LAW says about reimbursement and what our court orders say.

The last letter on 12/30 was a recap of the actions of his wife over the years, letting him know that I will be bringing up this issue before the Judge when we go back to court at the end of January 2005.

6-18-04- Thomas sent L a card. It was a congratulations card. It had a white flower on it. He addressed the envelope himself. He signed his name and added a heart. He wrote, “I hope you like this flower and my picture.”

11-30-04- J gave (8:31 am) a list to Keith suggesting what to get the kids for Christmas. He had only asked about L, because he was no longer discussing N with her. She gave ideas for Both kids. 10:40am, Keith told her thanks for the ideas, he appreciated it. Reminded her he doesn’t talk to her about N, but did tell her that he had sent N a birthday card in September and N refused it, not once, but twice.

12-20-04- received card from L. She wrote, “Richard (AKA) Dad” It’s postmarked 12-16-04. It was addressed to “Mr. & Mrs. D*******” in J’s handwriting.

12-21-04- Keith emailed (12:16am) J asking where to send L’s gifts, her home or her mothers. J responded (7:33am) to send L’s gifts to her home or her work. We sent the package to her home. (PO Box)

12-27-04 Keith emailed (1:46 pm) J asking if the box got to L yet, that it was mailed on 12-21.

12-28-04-J asked (7:50 am) where he sent it, that no box has arrived. Keith told her (7:59 am) he sent it to her PO box. He checked the postal tracking and emailed (12:54pm) J back and said, “It’s there now, today, a note was left in your PO Box that it’s there.”

Spring- DENIED

Summer- DENIED

Winter-DENIED

“Kiwanis International is a global community of clubs, members and partners dedicated to improving the lives of children one community at a time.” https://www.kiwanis.org/about

What an awesome statement! That’s why it’s so crazy to me, every time I see this, how a (current or past, not sure which) President of the Kiwanis club can call another mother’s children, “dumpy.”

While complaining about the fact that Keith and I found out about another claim for his daughter was processed incorrectly, his ex thought it was ok to throw these comments in:

“…I process the claims the right way, I went to your dumb ass providers, we suffer each time I have to take (her daughter) to the doctors and she feels it too. Why so you can sit in your dumpy little house with some dumpy wife and kids…”

This is not the first time she’s attacked my children.

She was also not happy when I called her insurance because once again, a claim was not processed correctly. Her insurance paid as Primary, and she wasn’t about to let them know.

To me, having her insurance pay claims as Primary, when they clearly are not, sound like fraud. When she found out I called her insurance to let them know, she wrote an email at 11:44am stating, “What fucking right do you have to call my insurance you bitch, Big fat ass stupid bitch- you know nothing of what you are talking about. STAY the fuck away from me and my insurance. Stupid fucking bitch. I am on the phone with my insurance and you have been reported as breaking the confidently and privacy act with them. STAY out of this it is none of your business.”

At 11:45 she sent another email saying two words, “FUCK YOU”

At 2:22pm, I emailed her back.

“Happy Holidays (her name) 🙂

Your actions, did I stutter? I did call the Fraud hotline (for her insurance) and I asked them if your actions constituted fraud since it isn’t the first time you have pulled this stunt, they transferred me to your insurance to discuss it with them. We discussed this claim. Simple as that.

I do know what I am talking about 🙂 I wrote down names of people I have spoken to at your insurance and ours, and took very good notes on what was said. I don’t go near you to stay away from you. Since you live in WA an I live in CA. There is about a 24 hour or so driving distance between our homes, hardly “close by.” Stay away from you or else…what (her name)? Sure sounds like a threat (her name). Are you threatening me? Sure hope not. You already tried to threaten me several years ago when you told me you have been diagnosed with (her diagnosis), remember? I still have the tape of that conversation. The Corporate office to your insurance is in Seatte, so I don’t think I will be getting there anytime soon eithre. No need for threats “(her nickname)”. Were you ever diagnosed with with Tourette Syndrome? https://tourette.org/resource/understanding-coprolalia/

There was not breach of “confidently and privacy act.” I did speak to your insurance rep VERY confidently though, thankyouverymuch. In fact, one of the reps and I had a nice conversation about the information they can and cannot give out. Calling for the status of claims is not a breach of “confidently and privacy act” as you like to call it. I had the information they asked for, and all I did was let them know they paid the claim incorrectly and asked for the address to mail them the primary EOB when we get it. What they did tell me was that they were not able to discuss any medical history with me, OR with your for that matter without (her daughter’s) authorization, and frankly, that would be TMI for me to know. I was also told that you put a password on which really made me laugh, because you act like you have something to hide.

I will take care of whatever Keith asks me to take care of regarding the insurance. Just so you know. Thanks for your email. :-)” and I signed it “Dumpy”

I guess the fact that she has continued as she always had to pay for services up front, then bill the insurances and get overpayments, and then turn around and bill Keith and complain to him and the kids that he doesn’t pay his share of expenses.

Whatever….

BUT, lets not forget, all this time, she has been a President of the Kiwanis club.

How ironic.

At 0813 am, on Dec 22, the ex wrote back, responding to my email from yesterday. She was not happy, LOL.

She said I don’t know what is going on at her end. UM, yes, I do. It could be considered fraud, not billing correctly, then getting reimbursed for claims not being billed properly then complaining to Keith about how he never pays his share. But, I digress.

She said herself, “…I know there is coverage with (our insurance) I just thought going through (our Reciprocity coverage) directly cut out the bullshit of having to deal with submitting to 3 different companies.” THAT is her 1st problem, she THOUGHT. Then she THOUGHT wrong, her second problem. Then she says, “I thought (our Reciprocity coverage) paid the claims directly. I found out later that is does not cut out the middle man, only it leads to more crap to contend with.” See, she BROUGHT THIS ON HERSELF. IMPATIENCE. She says, “If (her insurance, our insurance and Reciprocity) fail to process claims in the correct way that is not my fault or concern. I am not their watchdog.” LMAO…. It just sends her into a TIZZIE when we find out how she tried “to cut out the middle man” and screwed up the billing then we go in and straighten it out.

Case in point, she writes, “the shitty sarcastic comments made by your wife are unnecessary because she has not one clue of anything. She is the reason your children no longer speak to you-Merry Christmas.” See, she’s pissed off and throws daggers at him about his kids, because of HER fuck up.

So NOW her story changes…remember what she said yesterday, how she was already paid, etc…ok so now she says something totally different. She says, “(our Reciprocity coverage) gave me the statement of charges- I thought we were done at that point and it did submit it to my insurance and my insurance denied the claim pending primary insurance EOB. Then I submitted the statement to (our Primary) after calling (her provider) at (our Reciprocity) and the persons who handle Reciprocity for my at (our Reciprocity coverage). From there they told me to submit directly to (our Primary) which I did. I never needed your flippin nosy wife to stick her big nose in this at all. ” HUH?? She claims she did process the claim the correct way (no she didn’t). then she starts again…

“what’s the big deal anyhow. You won’t reimburse me for anything? Just want to be sure you are not left out? What the fuck ever. Don’t let your wife ruin your entire life. It is taken care of and if there are any mistakes then the insurance company will figure it out. I process the claims the right way, I went to your dumbass providers, we suffer each time I have to take her to the doctor and she feels it too. Why so you can sit in your dumpy little house with some dumpy wife and kids and tell me I am messed up. Look in the mirror again. I am spending time Christmas with (daughter) and (son) does talk to me. In fact (son) and (daughter) both are very close to me. Whose screwed up or maybe whose jealous. Get over it and stop your wife from making the bullshit remarks she knows nothing about.”

I called her insurance to let them know they paid this claim incorrectly. I told them our Primary carrier has not processed the claim, and that as of yesterday, the claim was pending, needing information from the provider, but it was being updated. I let her insurance know what our Primary carrier had received the claim (dated 9/13/04) on 11/24/04. Her insurance rep looked into the claim and discovered the claim was paid because the “estimated” the coordination of benefits, and that they paid the claim on 12/6/04. They told me that when we get the eob from our Primary carrier, then it needs to be resubmitted with the claim number that the ex has, to them, along with the a letter stating that this is the CORRECT information and request that the claim be reprocessed correctly. I emailed Keith and her this information. SHE was not happy. She said at 1142am: “(Her insurance name) is my insurance and I will talk to them. You have no right to talk to them about anything especially something that does not involve you.”

Then she responded at 1144am to my response that her actions will be reported as fraud. She wrote, “My Actions- LOL what fucking right do you have to call my insurance you bitch, Big fat ass stupid bitch- you know nothing of what you are talking about. STAY the fuck away from me and my insurance. Stupid fucking bitch. I am on the phone with my insurance and you have been reported as breaking the confidently and privacy act with them.

STAY out of this it is none of your business.” LMAO!!! Sorry, but that made me laugh. I can call to find out the status of claims as my husbands representative. What a goof ball she is. Calling for the status of claims is NOT “breaking the confidently and privacy act with them” They aren’t giving me any information but the status of the claim, the money part.

She’s just pissed she got caught again, not billing for claims properly.

Keith responded to this one at 532pm, writing, “hard to imagine how you keep a job working with the public. Keith” How RIGHT he is, and the way she trash talks mine and Keith’s kids, how is it that she can be a president of the Kiwanis club?

OH, but her 3rd response was classic, at 1145am she whipped off a third response of two words, “FUCK YOU”

At 1146am she wrote again, “All email addresses from you stupid (our last name) has been blocked- Happy new year”

At 222pm- I wrote her back:

“Happy Holidays (her name),

Your actions, did I stutter? I did call the (her insurance name) fraud line and I asked them if your actions constituted fraud since it isn’t the first time you have pulled this stunt. They transferred me to your insurance to discuss it with them. We discussed this claim. Simple as that.

I do know what I am talking about 🙂 I wrote down names of people I have spoken to at your insurance and ours, and took very good notes on what was said. I don’t go near you to stay from you. Since you live in WA and I live in CA. There is about a 24 hour or so driving distance between our homes, hardly “close by” Stay away from your or else….what (her name)? sure sounds like a threat (her name). Are you threatening me? Sure hope not. You already tried to threaten me several years ago when you told me you had been diagnosed with (the diagnose she gave me), remember? I still have the tape of that conversation. The Corporate office to your insurance company is in Seattle, so I don’t think nI will be getting there anytime soon either. No need for the threats (“her nick name”).

Were you ever diagnosed with tourette syndrome? (provided a link)

There was no breach of “confidently and privacy act” I did speak to your insurance rep VERY confidently though, thankyouverymuch. In fact, one of the reps and I had a very nice conversation about the information they can and cannot give out. Calling for the status of claims is not a breach of “confidently and privacy act” as you like to call it. I had the information they asked for and all I did was let them know they paid the claim incorrectly and asked for the address to m ail them the primary EOB when we get it. What they did tell me was that they would not be able to discuss any medical history with me, OR with you for that matter, without (her daughters name) authorization, and frankly, that would be TMI for me to know. I was also told you put a password on which really made me laugh because you act like you have something to hide.

I will take care of whatever Keith asks me to take care of regarding the insurance. Just so you know. Thanks for your email. “Dumpy” (that’s how I signed it.)

Whether they’re vision, dental, medical claims, the ex always makes mountains out of mole hills. She bills incorrectly, then when I call for the status of a claim that SHE is waiting for reimbursement that she is waiting from Keith, is when Keith and I discover how screwed up the claim is.

In one particular case, she was claiming her info was correct, but since I know she can’t even handle our insurance properly, I KNOW her info is not correct.

When I emailed Keith about this claim, I cc’d her, to keep her in the loop. She responds at 1012amwith “I have already received payment for this claim. Must have gone through (our insurance) and then submitted to (her insurance). As I have already received all the amounts paid out of pocket. This is what happens when you have too many cooks in the kitchen. I already had it handled and then you get in the middle and whoops there it goes. HEY I might just get paid twice, Yeah (Her name).”

At 1233pm, I emailed Keith and her, but addressed Keith only telling him again that the claim had NOT been processed through our insurance, that the claim pended. I let him know that the ex had called his insurance on 10/29/04 requesting an EOB and that on 11/3/04 an itemized statement was faxed to “Consumers mother.” I told him that the ex called our insurance again on 11/16/04 regarding reimbursement for this claim, that she had told Reciprocity there was no coverage for this particular claim through our insurance. I told him that I read our coverage to Reciprocity, and told them our insurance has paid these claims in the past, and that his ex is well aware of this. I told him that what it sounds like was that his ex took the faxed statement she had received and billed her insurance for reimbursement, and that it was very possible that her insurance had no idea there was a Primary insurance carrier, HIS.

The claim from Sept. has been pended. According to our insurance, they pended the claim, needing more information. They sent two letters out to the provider, one on 12/8 and another one on 12/20, yesterday. With the holiday coming up, the pending status will more than likely be extended. Oh well….I let Keith know via an email to his Weblink wireless pager.