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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 FOC with a copy of the entire packet that was previously mailed to the other party
a. Be prepared to show proof to the FOC the date the packet was mailed to the other party.
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 FOC with a copy of the entire packet that was previously mailed to the other party.
a. Be prepared to show proof to the FOC the date the packet was mailed to the other party.
FOC Office:
Once we receive the completed 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:
Payee: The amount will be added to the support account in our office as a medical reimbursement (MR) obligation and will be collected along with other support obligations by either adding to the Income Withholding Order or any other enforcement actions necessary.
Payor: The monthly support obligation will be reduced by the amount of the medical expense.
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 FOC with a copy of the entire packet that was previously mailed to the other party
a. Be prepared to show proof to the FOC the date the packet was mailed to the other party.
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 FOC with a copy of the entire packet that was previously mailed to the other party.
a. Be prepared to show proof to the FOC the date the packet was mailed to the other party.
FOC Office:
Once we receive the completed 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:
Payee: The amount will be added to the support account in our office as a medical reimbursement (MR) obligation and will be collected along with other support obligations by either adding to the Income Withholding Order or any other enforcement actions necessary.
Payor: The monthly support obligation will be reduced by the amount of the medical expense.