FOR PAYEE:
In order for us to enforce reimbursement for medical expenses, you must first:
1) Pay the annual ordinary medical amount per your current Uniform Child Support Order
2) You must provide the medical expenses to the other party within 28 days of either the date the insurance provider has paid on the expenses or the date the insurance provider denies payment
a. Complete the Request for Health-Care Expense Payment form
b. You will need to complete the form and the chart;
c. Mail to the other party with copies of the Explanation of Benefits, Provider Account Statements, Receipts, etc;
d. If he/she does not respond to you within 14 days to make payment or payment arrangements then;
3) You will need to complete the Complaint and Notice for Health-Care Expense Payment and supply to the Friend of the Court with a copy of the entire packet that was previously mailed to the other party
a. Be prepared to show proof to the Friend of the Court the date the packet was mailed to the other party
Once we receive the completed Medical Reimbursement Packet, we will mail a copy to the other party. He/she will have 21 days to respond to our office. If he/she fails to respond regarding payment or payment arrangements, we will add the amount to the support account in our office as a medical reimbursement obligation. This amount will be collected each month along with any other support obligations by either adding to the Income Withholding Order or any other enforcement actions necessary.
The Medical Reimbursement Packet has been enclosed for you. You may make as many copies as needed. Additional forms are available on our website at www.menomineecounty.com, under Departments, under Friend of the Court, under Forms or in our office. Instructions are included; please follow them carefully.
If you have any further questions, please contact our office.
FOR PAYOR:
In order for us to enforce reimbursement for medical expenses, you must first:
1) You must provide the medical expenses to the other party within 28 days of either the date the insurance provider has paid on the expenses or the date the insurance provider denies payment
a. Complete the Request for Health-Care Expense Payment form
b. You will need to complete the form and the chart;
c. Mail to the other party with copies of the Explanation of Benefits, Provider Account Statements, Receipts, etc;
d. If he/she does not respond to you within 14 days to make payment or payment arrangements then;
2) You will need to complete the Complaint and Notice for Health-Care Expense Payment and supply to the Friend of the Court with a copy of the entire packet that was previously mailed to the other party
a. Be prepared to show proof to the Friend of the Court the date the packet was mailed to the other party
Once we receive the completed Medical Reimbursement Packet, we will mail a copy to the other party. He/she will have 21 days to respond to our office. If he/she fails to respond regarding payment or payment arrangements, your monthly support obligation will be reduced by the amount of the medical expense.
The Medical Reimbursement Packet has been enclosed for you. You may make as many copies as needed. Additional forms are available on our website at www.menomineecounty.com, under Departments, under Friend of the Court, under Forms or in our office. Instructions are included; please follow them carefully.
Complaint and Notice for Health Care Expense Payment
Request for Health-Care and Expense payments
| Contact: |
Jodie L Barrette - Friend of the Court
Phone: 906-863-8981
Fax: 906-863-2649
Click here to email |
| Address: |
839 10th Ave.
Menominee, MI 49858
Map |
| Office Hours: |
7:30 a.m. CST - 4:30 p.m. CST
Caseworkers available after 4:00 p.m. CST by appointment only.
Clients are encouraged to make payments online at www.misdu.com, by mail to MISDU, P.O. Box 30351, Lansing, MI 48909 or at www.govpaynow.com using pay location 9154.
Cash payments and correspondence/forms can be enclosed in an envelope and placed in a secure box in the Courthouse vestibule. |
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