Claims

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.