Can I get in trouble for keeping health insurance checks?

[Gwill24305]

My health insurance sends me checks directly whenever an out of network provider is used. These are typically bulk checks which include everyone on the plan.

My stepson (I am Non Custodial Step Mom) is covered under my plan as SECONDARY insurance. Doctors won't give me breakdown, his mother won't talk to me or my husband (child's father) and checks aren't making sense. The doctors send us a statement saying pay X with no breakdowns because of HIPPA - but they know the insurance company sent me checks. The pay X does not add up to any of the checks.

Will I get in trouble if I don't forward them on to doctors office? I don't believe some of the checks are completely for his bills entirely, but can't figure it out. Can stepson's mom sue me? Can doctor sue me? Can I get arrested?

I just don't pay medical bills or turn over insurance checks unless the figures match because there is so much fraud out there.

[AFFA]

I wish to inform you that if you encash a health insurance check that does not belong to you, then you may get into trouble. On the other hand, if you encash a check for money that is not owed to you then also you may get into trouble. This could happen in the case of over payment, payment by mistake, wrongful payment, etc. by the insurance company. The insurance company during audit is likely to find out its mistake. Most insurance contracts have a clause that you will pay pack any money received by mistake and not owed to you. It is best not to encash a health insurance check not owed to you.

AFF

[Rosalinda993]

Of course it is not right to encash health insurance checks not under your name. With the skyrocketing average cost of health insurance, that check would be used by the person who needs it the most. In short, encashing any checks not under your name is not right.

[Gwill24305]

Rosalinda993 - you posted after I deleted the whole context of my message (Husband's Ex stalking me on forums).

I agree with your point - it is wrong; however the checks are in my name. They are bulk checks that include my husband's, my son's, mine, and my stepsons claims. The insurance will send checks and sometimes there is no EOB with all of it. The insurance pays me directly for out of network providers. When I call stepson's Dr.s to get a breakdown so i know how much to forward - they refuse to talk to either myself or my husband (patient's father) as his mother (husband's ex) has told them not to talk to us.

The Dr's send us a bill with just dollar amount balance that does not add up to any of the checks I've received. His Ex wife, who the boy lives with - will not return calls, respond to mail or e-mail with requests we've made to break it down for us.

My own insurance has indicated that because he is now 18, they will not talk to me or his father, even though i'm the subscriber to explain. They instructed me to keep the checks as they are bulk for multiple claims and not forward to anyone until I have exact accounting of the charges. Just as I do for my own bills, medical or not.

As no one will give us a break down - I refuse to send money until their accounting matches what I believe is to be correct. So we sent a note to his Ex explaining to bill us with what she has and we will forward accordingly.

She told a relative of my husband's that if I don't forward all of the checks - she will press charges for theft. Now, remember - these are bulk checks that sometimes include payments for my doctors and our child's doctor - I am not sending the full check amount to her doctors because it is not all intended for my stepson.

I just wanted to know, with this complicated situation and I have documented every phone call and written correspondence - can I get in trouble for not handing over the full amount. I believe her demanding the full amount is theft as not all of the payments are for my stepson. She would be stealing from doctor's payments.

[Rosalinda993]

Originally Posted by Gwill24305 Rosalinda993 - you posted after I deleted the whole context of my message (Husband's Ex stalking me on forums). I agree with your point - it is wrong; however the checks are in my name. They are bulk checks that include my husband's, my son's, mine, and my stepsons claims. The insurance will send checks and sometimes there is no EOB with all of it. The insurance pays me directly for out of network providers. When I call stepson's Dr.s to get a breakdown so i know how much to forward - they refuse to talk to either myself or my husband (patient's father) as his mother (husband's ex) has told them not to talk to us. The Dr's send us a bill with just dollar amount balance that does not add up to any of the checks I've received. His Ex wife, who the boy lives with - will not return calls, respond to mail or e-mail with requests we've made to break it down for us. My own insurance has indicated that because he is now 18, they will not talk to me or his father, even though i'm the subscriber to explain. They instructed me to keep the checks as they are bulk for multiple claims and not forward to anyone until I have exact accounting of the charges. Just as I do for my own bills, medical or not. As no one will give us a break down - I refuse to send money until their accounting matches what I believe is to be correct. So we sent a note to his Ex explaining to bill us with what she has and we will forward accordingly. She told a relative of my husband's that if I don't forward all of the checks - she will press charges for theft. Now, remember - these are bulk checks that sometimes include payments for my doctors and our child's doctor - I am not sending the full check amount to her doctors because it is not all intended for my stepson. I just wanted to know, with this complicated situation and I have documented every phone call and written correspondence - can I get in trouble for not handing over the full amount. I believe her demanding the full amount is theft as not all of the payments are for my stepson. She would be stealing from doctor's payments.

Wow, that is pretty complicated... She cannot press charges for theft since you have bulk checks. You are right in saying "demanding the full amount is theft as not all of the payments are for my stepson. She would be stealing from doctor's payments"

Have you consulted with anybody on this matter? This is pretty complicated and involves a lot of people...