I actually know a bit about pediatric emergency rooms.
A few things you can do is first find out the child's "walk-in" policy at the primary care provider/pediatrician (PCP) for illnesses (by calling there as though you're a new parent) and inquire as to any higher cost for "walk-ins" per se, so you have the facts ahead of time. Ask about waiting for an urgent appt and the risks associated with this as well as their directives for diagnosis specific symptoms (eg: asthma). The American Lung Association, American Academy of Pediatrics, and even the CDC all have excellent info for parents re: contagious illness, vaccines, latest recommendations/treatment modalities etc. Arm yourself with education to best benefit your little girl. Remember to ALWAYS clearly get the doctor's home care orders and never treat your child on your own without medical direction...you could do more harm than good even if you mean to help!! If you ever have a doubt, you have a gut instinct for a reason, SO ASK. There's never a "bad" or "silly" question except for when you don't ask it!
Perhaps request a copy of the discharge instructions for each ER visit made (maybe in the modification of your child support agreement), so both you and your ex are accountable to be sure and fulfill all of these measures to limit re-visits for the same problem, as well as to appropriately pursue needed follow up. Review this with your attorney.
If your child is (ex) asthmatic, perhaps you'd even like to make an appt with her PCP for educational purposes, so you know if all is being done from a PCP and custodial parent perspective to limit acute ER visits. Find out if there has been a history of compliance from her custodial parent. Your ex-wife might truly be doing all she can to care for your daughter. Maybe she works and cannot take off work for frequent appts. Maybe you can help with this if your daughter can be seen at the PCP's office during business hours. What MD would argue with a noncustodial parent showing this interest in the education about her illness issues if you were to pay a visit to the PCP's office? Just remember to not be/act angrily, and to remember this is for your daughter. Go with with enough time to really sit down and discuss your concerns. Ask her teacher to call you/your ex-wife if he/she observes anything that's a problem, so you'll both be advised at each exacerbation, and you might be able to offer your help.
Also inquire if subspecialty is needed for even just a one time assessment (to mark in time "this is how Suzy was at age 7") by a pediatric pulmonologist, so they can evaluate your little girl and perhaps review the adequacy of the PCP's management of symptoms thus far. It might not be the PCP's fault if he/she has not had an opportunity to see the child with each episode, where a variation of "polypharmacy" prescriptions are made and perhaps duplicated or missed altogether, since a different doctor might be treating at each time in the ER. It sounds like she has a frequent cough...maybe frequently. If she is in fact asthmatic, many PCP's have a built in immediate regimen to prevent the symptoms from becoming acute. Maybe the PCP has an after hours "Telephone Triage" service hooked up with his/her office, staffed by pediatric RN's who answer questions based on algorithms and reported symptoms, that you/your ex can call in the event of symptoms, so they can direct you on the most appropriate next step. Your showing an interest in this manner would only benefit your little girl, and quite possibly enhance your credibility with the court system, so this proposal would be taken seriously, as you are not asking anything of your ex that you are not willing to do yourself.
Another argument to be made against ER visit is that the child is probably seeing a different doctor every time she goes to the ER, thus precluding the PCP from giving your child the quality of continuity of care she deserves from a pediatrician who would likely know her much better if she made use of the PCP's office appropriately.
You would be exposed to contagious illnesses in any waiting room, be it ER or PCP's office, but an ER visit means you might be exposing your child to contagious illness form an adult perspective (eg: TB, other pneumonias) if the waiting area is not a sequestered waiting room for children and parents only. I'm quite sure neither you nor your ex want to be exposed in this manner either. ER visits are potentially more costly in not just a financial way but from a health perspective also.
Your initial steps might prove costly in the way of time and money to visit PCP, your attorney and possible re-visiting the court scenario for agreement modifications, but in the long run, your little girl will benefit and one day thank you for acting on her benefit with education and further investigation behind you both.
I do not by any means suggest that if she truly has an acute need, that she do anything but immediately go to the ER. Education from your PCP and subspecialist would be you/your ex's navigation points to reference when you have a doubt. Make sure you have (ex)a nebulizer, mask, and tubing with appropriate supply of (ex) aerosol treatments at your house for when she comes to visit, so you can immediately intercede with doctor's ordered treatment if this is deemed necessary. DO NOT TREAT WITHOUT THE DOCTOR'S ORDERS!!!!! AND REVERIFY THESE FREQUENTLY!!!! (Know what EACH med is for, insist on an explanation, this is your right!)
Know the facts, the most up to date treatment regimen, and present this in a way where it will benefit everyone in a nonaggressive manner maybe with some of the above in mind, and it seems only natural that all will agree this will be better for you all, esp your little girl. She is counting on you and your ex to act on her behalf and minimize any turmoil. Keep your communications with your ex calm and to the point, and ask for repeat verbal verification from your ex with each arrangement/discussion, ...email is perhaps a good papertrail that can be referenced later. Just be sure to be discreet on the internet about your daughter's identity info, like DOB, SSN, diagnoses, test results, etc in emails, as children are one of the highest populations accessed by identity thieves.
I wish you success and the best of luck in caring for your healthy little girl. Don't be discouraged, this will all work out with a little effort, patience, and faith.
First of all it's too bad you can't speak to your ex to try to work this out, that would obviously be the 1st thing to try, however if you can't then you must petition the court to modify your current child support agreement. I would be sure to obtain documentation to back your issues up first, because if she's going to the ER on a monthly basis rather than seeing her primary care Dr. then this is unreasonable, however if she's gone 3 or 4 times a year and your ex truly felt it was urgent then the judge will more than likely shoot you down. It will come down to reasonable versus unreasonable.....As far as the CA getting these bills before you lay eyes on them, thats a real problem. Is your ex- wife is requesting the uninsured portion (assuming its co-pays) of the bill be mailed to you? Obviously not. Do you see your child often? I would imagine that if your being told she went to the hospital you have asked for the bill, or even called the hospital?? Just wondering........I just figured if you know she went to hospital.. don't wait for a bill since youv'e been getting them from collections, be proactive, ask your ex for exact dates or call the hospital + request a bill until your C.S. child support order is modified. Sounds as if you will need to add this to your modification request as well. Bring the CA's to court with you and be prepared to PROVE your case, Remember YOU have the BURDEN of PROOF, not her. Just a word of advice: The 1st reply you recieved also told you the same thing(and was ,less wordy, Sorry) but added that if its not stipulated in your divorce you can just deduct co-pays from child support.....I would be very, very cautious here. You have to be SURE that is the case, don't just take it upon yourself to deduct from child support, you cannot alter, change or deviate from an order from a court in ANY way or you will be the one in the hot seat! Sorry was so long...Best of Luck!!