Self-Insured QMCSO

[karen1027]

My children are covered under a self-insured health insurance plan under their father's firm. I have finally started to get checks from the insurance company; however, the checks are "voucher checks". I am not receiving explanation of benefits for these checks. Shouldn't I receive an explanation of how these claims were paid as well as an EOB when there is no payment or the payment goes to someone else?

I'm also confused as to why I get these voucher checks rather than the "normal" check one usually gets from the health insurance company.

[Guest sniffles]

You should receive an EOB each time. If you are not receiving them you should call your insurance company and find out why.

[karen1027]

You should receive an EOB each time. If you are not receiving them you should call your insurance company and find out why.

I'm getting no where with the insurance company. It's hit or miss that I receive reimbursement checks. What specialty lawyer would I contact to assist me with getting the insurance company to comply with a QMCSO?

[leevena]

You should receive an EOB each time. If you are not receiving them you should call your insurance company and find out why.

I'm getting no where with the insurance company. It's hit or miss that I receive reimbursement checks. What specialty lawyer would I contact to assist me with getting the insurance company to comply with a QMCSO?

Sorry to hear about your frustrations. Hard to say what type of attorney you will need. If you do not get a recommendation from anyone, you may want to try researching/calling attorney's in your area. Even if they will work in this field, you may find some that don't want to litigae.

[karen1027]

One additional question, insurer now claims (but hasn't done) that any child over the age of 21 will receive the reimbursement check rather than the custodial parent. Is that accurate? NO checks have been issued to them..

[karen1027]

No one wants to litigate this - insurance company os blatantly ignoring the Order.

[Guest sniffles]

What is the name of the insurance company? Is it a well-known company?

Also have you contact them personally, or the court where you received the Order?

Maybe your state department of insurance?

[leevena]

If this group is self-funded, then the insurance company is not responsible. You need to work with the plan administrator.

[karen1027]

Just been advised by insurance company that company has removed QMCSO..... I am no longer receiving reimbursement checks. Round and round we go

[Guest sniffles]

Contact the Court that the order was issued from to see what your recourse is.

[karen1027]

The insurance company now states that they will issue reimbursement checks to the children (i.e not me the custodial parent who paid for these services and is indicated on the QMCSO as the alternate recipient custodial parent). The Order states:

Any payment of medical benefits made pursuant to this Order is reombursement of expenses paid by an Alternate Recipient

or an Alternate Recipient's custodial parent, as applicable, shall be made to the Alternate Recipient or the Alternate

Recipient's custodial parent paying such expenses.

Of course, I, nor my kids, haven't received any checks but shouldn't the checks be issued to me?