Third-Party Payments: Insurance Companies and Ex-Spouses

By state statute, both parents are responsible for their minor (under 18) child’s debts. While we will send a statement to whomever is designated on the front side of the registration form, each parent is wholly liable for timely, full payment for care delivered by the practice, as well as any other fees incurred. Divorce proceedings do not alter this basic responsibility. Court judgments that one parent is “responsible” refers to the relationship between the parents; it does not affect the contract with a medical office. Agreement with an insurance company is legally viewed similarly. Thus, waiting for an ex-spouse’s or insurance company’s payment is not an adequate reason for late payment of fees.

Some health plan members (including Anthem Blue Cross Blue Shield, Aetna, CIGNA, ConnectiCare, United Healthcare, Connecticut HUSKY) are also covered by other insurance. Unless we are participating members and the health plan is the primary carrier, all charges incurred by these families are treated as personal charges. Why? The health plans refuse to pay unless we submit a denial from the other (primary) carrier. Only the patient is able to get such a denial. Many patients have been neither providing us with those denials nor paying for their visits. Time limits for submission to the health plans elapse (within as few as 60 days), and the charges go unpaid forever. Upon payment of the outstanding balance and receipt of a claim denial from the primary carrier, we are happy to submit claims to the health plan for those patients. Any amounts paid to us by the health plan will be refunded to you.

Essex Office One Wildwood Medical Center
35 Saybrook Road
Essex, CT 06426
Tel: 860.767.0168

8:30 am to 5:00 pm M-F
8:30 am to noon Saturday

Ped-I-Care After Hours Care
Available in Our Essex

6:00 pm to 8:00 pm M-F
Noon to 5:00 pm Saturday
11:00 am to 4:00 pm Sunday & Holidays

Old Saybrook Office 30 Elm Street
Old Saybrook, CT 06475
Tel: 860.388.4545

8:30 am to 5:00 pm M-F

NCQA Recognized