Extraordinary Medical Expenses
The health care expenses of all payers of child support will be processed as
extraordinary medical expenses and the expenses will be apportioned between the parties according to the medical expense percentages established in the support order. The Ordinary Medical Expense (OME) noted in the support order is not deducted from the medical expense claim of the payer of child support.
Submitting a Formal Claim
To submit a formal claim, the following process must be followed.
Using the Friend of the Court (FOC) official Request for Heath Care Reimbursement Form the requesting party must request payment as soon as possible after the expenses have occurred, or within six months after the date of the insurance company’s final payment or denial of coverage. Each expense must be entered on the form itemized. In addition, you must provide copies of the bills, receipts, and proof of insurance payment. The bills must include the following:
- Copy of signed orthodontic contract if applicable
- The date of service
- Explanation of Benefits (EOB) from the insurance providers
- The name of the child receiving the services
- The name of the provider
- The nature of the service
- Statement from the provider
Pursuing Further Action
You must allow the other party 28 days to respond to your request for payment. If no response or payment is received within 28 days, you may send a copy of the Friend of the Court Request for Health Care Reimbursement Form, with the copies of all the bills, and also the previously noted information. The forms must be completed in their entirety or they will not be processed.
Any medical expenses submitted to the FOC for processing with the completed forms, but which do not have the required proof attached, will be returned unprocessed. Do not fax the medical packet.
Processing of Your Complaint
Upon receipt of the official forms and appropriate documentation by the FOC, the complaint will be processed and a determination will be issued to the parties setting forth the amount owed. If a written objection is not filed within 21 days after the date the notice was mailed, the FOC will set up a separate medical reimbursement account.