Practice Management Alert

A divorce decree is an often-cited reason for not paying a child's medical bill or other medical debt, but that doesn't mean it's a legitimate excuse.

Recent divorcees may react to a collection call from your practice with anger, resentment or sadness - but you can increase your chances of smooth sailing by removing the divorce decree from the discussion. Check out this collections complaint and determine how you would handle the situation:

Problem: I recently called to follow up on a past-due account and the pediatric patient's mother told me that she and her husband are recently divorced, and the court order says he is responsible for paying the medical bill. I felt very awkward and didn't know how to proceed with the conversation. Any advice?

Answer: Billers should be very careful to avoid the "ping-pong effect," in which you are endlessly bouncing back and forth between the husband and wife trying to figure out who will pay, says James Christensen, MCE, president of J C Christensen and Associates in Sauk Rapids, Minn. If you simply get the ex-husband's contact information from the woman and hang up, you've just blown a perfect opportunity to gain her willingness to assist you in settling the debt, he says.

Best practice: Lay the divorce decree aside, Christensen says. A divorce ruling is between the husband and wife, and it doesn't legally release either party from financial responsibility of a debt. Follow these two steps for the most productive conversation possible when you encounter a decree-wielding ex-wife:

1. Acknowledge what the ex-wife said. Tell her you understand the divorce decree may very well have directed her ex-husband to resolve the debt, and gently ask her how you can reach him to discuss this further. Collect that contact information as tactfully as possible, and file it away for later.

2. Explain her legal responsibilities. You should align yourself with the woman so she feels that you understand her situation, but also be clear that she is ultimately responsible. Walk this fine line by saying something like, "I'm going to try to work with you and your ex-husband, but please understand that you are also responsible and may have to help get this bill paid."

Tip: Be friendly but firm. Talk in terms of what you can realistically control, rather than giving a false sense of hope.

Emotional disclaimer: Divorce is clearly a very emotional transition, and those emotions "can often stand in the way of a reasonable discussion," Christensen says. If you find the woman's emotions are too high to continue, you're better off adjourning the discussion and waiting for another day, he says. Otherwise, you risk getting the woman so upset that you make an enemy - and that's the last thing you want in such a sticky situation.

Make no mistake: A court order takes the back seat when medical bills are involved. For instance, if a recently divorced couple is squabbling over who should pay their child's medical bill, "whoever brought the child to the medical provider and signed off on the paperwork is legally responsible to pay the bill," says Gary Kinne, president of Asset Recovery Inc. in Rutland, Vt. The court order simply gives one spouse the legal right to pursue the ex-spouse for recovery of the medical debt after the medical provider receives payment, he says.