HomeMy WebLinkAbout96-02516
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3. The Defendant, TERRY W. GERMANN, JR" is an adult Individual residing at 2 North
Enola Drive, Enola, Cumberland County, Pennsylvania 17025-2515.
4. Belween the dates of May 18, 1992, and through April 7, 1994, and on the specific dates,
in the specific amounts, and for the specific services as set forth In a true and correct copy of the
Plaintiffs Statement of Account hereto attached, made a part hereof and marked Exhibit "A", Plaintiff
performed labor and provided medical services and products of the kind and description set forth on
said Exhibit for Defendant, Noelle J. Hartman-Germann.
5. The prices charged for said labor, services and products provided were just and
reasonable, were the legal and market prices therefor and were the prices which the Defendants orally
promised and agreed to pay Plaintiff therefor.
6. At the time this labor was performed and services and products provided, Defendants
were insured through Defendant's, Noelle J. Hartman-Germann, employer, with Blue Cross/Blue Shield
medical coverage.
7. Plaintiff was not at this time a "participating" physician; therefore, any and all funds paid
on behalf of Defendant, Noelle J. Hartman-Germann, by the medical Insurer were paid dlrectiy to the
subscribers (Defendants).
BJH:COMPIlVORK\21858:4.23.98
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8. Plaintiff did, on behalf of Defendants, file medical Heallh Insurance Claim Forms with
Blue Cross/Blue Shield to enable Defendants to receive payment; all payments of which rightfully
should have been used to pay Plaintiffs fees for services rendered. A true and correct copy of the
forms completed are attached hereto, marked as Exhibit "B" and made a part hereof.
9. Defendants have acknowledged that they received minimum payment(s) totaling FOUR
THOUSAND ($4,000.00) DOLLARS from Blue Cross/Blue Shield, but "spent the money" rather than
forwarding It to Plaintiff In payment of the aforesaid monies owed.
10. Defendant, TERRY W. GERMANN, JR., Is joined In this Complaint as both Defendants
named herein benefitted from retaining the funds which were rightfully Plaintiffs; funds which were due
and owing to Plaintiff for services rendered and billed and which, in fact, Plaintiff helped Defendants
obtain by completing necessary forms.
11. The balance still due and owing by Defendants to Plaintiff Is the sum of EIGHT
THOUSAND, FIVE HUNDRED FIFTY-TWO DOLLARS AND FORTY CENTS ($8,552.40).
12. Plaintiff has frequentiy demanded payment from Defendants of said amount due and
owing as aforesaid, but Defendants have refused and neglected and still refuse and neglect to pay
said amount of any part thereof.
BJH:COMPllVORK\21 858:4.23. 98
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10121191 HHtASANf ~O WEEER tIO
102IVI-10~IVI Y0020-AP- -COlt' bVC IAPI 36M~ -Plfl
102191-IU21VI 92.~5 - -IVFA J62.0l -Pl~
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TicU 102669 U 0021 NlRU: G~IHMTI1AN Totall .,~~6.oo
lomm l.t'lEASANT NO WE~EJ1 NO HOP\:.crtlfl H1U
10ml-IOml 6'1218 . -f'ld'-aU 362.02 .PloR 1 2,226.00
110691- .1ILUIi t:liO~WBlll: ~lH-0102b6Yl.N.N-P cleared
110691- .CAPllAl BLlI: URUSS -0102b69~.N.N.P cleared
.00 I 1600.00 I JOO.~O I .00 I .00 I .00 I 12:i.20 If
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1I0491-1I0m . -N/C OFI'ICE VI .!62.oJ .Pfll 1 0.00
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11/11191 I.PHtASANr tIO WE6~ KO HlJIlC.CMP HIU
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112591-112591 - .N/C OfFICE VI J62.lIJ .Plill 1 0.00
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12/04191 l-t1EA!;AN1 lID wt;BER"D kU'C-CMI' HIU
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12/IIIVI 1-t'ttASt\'l1 no Wlil!<R no tlOPI:-~AII' HILL
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01/30192 l-I'HI:ASANT"O Wl:btH NO htJPC-CAItP HIU
012992-012992 b7m - -fRP-UO ~b2.u2 -~lll 1 ",~'Z6.00
020392- -IA.UE CMJSS/BLlE S1iJ-OIU3000I-N-IH cleared
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.00 I 1600.00 I 314.00 I .00 I .00 I .00 I ~"~.~'\1 UI'
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Tick' 112701 U 0000 NOEllE
04/Z3/Vl 1-11iEA~lVll NO IUER NO
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TiCk' 114484 U ??oo ootl.I.E li€RMlfllHARINAN Tohll 103,00
o:l/18tr.! l-PtI:ASAIH HO WEBER "0 klJi'C-tAI'I' HILL
051892-051av2 99113 - -~~TABlllilt:ll P ~62.0~ -PUN 1 50.00
05IB'12-0~llm r.l<.~ - .FUNDUS POOTOS 362.02 -PUl I 5:1.00
D:l1l192-051ll92 - -AOIl. ox J79.n -VIT It:IlOIlIilWl I 0.00
052692- -IA.UO CROSS/BlUE SHI-01144841-N-N-~ rejected
052692- -CAPITAL Slut CROSS -0114484l-N-N-P reJccted
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06/11/92 1-t1il:ASANT lID WEIlR no
061192-061192 WlIJ - -ESTAll.Il*D P ~62.02
061192-061192 - -AOll. ox 379.23
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062292-06W2 bn211 - .PIiP.OS 362.02 .PllR I 2,Z;:b.00
0629r2- .BLUE CRoSS/BLUE SMI-01Ibb941-Y.N'P cleared
0908'12' .CAPITAL DUJI:. OOSS '01l6694~.A-N-P c1ured
Zl2b.00 I 1600.00 I JOMO I .00 I .00 I .00 I m.20 Lf
....................................--..-....
TIck' 1:/0522 U OO~'f IOOlli Ul:H1\IWl(h>1o,,~ III lotill :.0.00
ool3lm 1-F1t:ASANI"U WUlffi"o H\Jf'C-CI\I1I' HILL
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110m. 110m ml~ - .ESTABLISHto P 362.02 -Pill I 50,00
110m-110m . .ADll. UX m.:i3 .YIT It:tIIlliliWlO 1 0.00
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--.........................-......................................-..........................-..........-..-.............................
TiCk' 12~2'dll U om Imu GERMNNIHARll'llN 10UII ~o.oo
i 11/11/'(2 ~.o1JAN 110 MtftR NO xOPC-uIMP HilL
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: 111192-1111'(2 - .AOlA. OX .!5O.~1 -0IAD rlrClJLOPA 1 0.00
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; 12/02/'f2 1-fH:A~lVlr 110 tll:el:R lID IilJPC.~AIf> HilL
: 120292-1:"'0292 '19m - .EbTAlU~O P 36M2 .~1Il I 50,00
: l20m-120".!'12 . .ADll. UX J79.~3 .VIf H:IIOllIiWlll 1 0.00
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I Tick. 1~6/59 U 0021 NOELLE GERMANHIHAR1~ Totill 2,l26.oo
; 12/r11/92 l-I'1itASANr"o tll:bER"D hU'C-lA/f' HILL
, I2089Hlom 61218 . .r'RP'UO 362.u2 .PIll I 2,226.00
1214Y2- .~UE CROSS/BLUE SHI-01~67~91.N.H.P cleared
121492- .~lIAL BLUO CROSS .012bi~9l.N.N.P cleared
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,
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i OIlI'rJ..BLUE DlOS~/BLUE SH1-01281601-N.N'P clurod
011193- .CAPITAL BLU< CROSS '01~~1602'H.N-P rejected
.00 I 1641.00 I .00 I .00 I .00 I .00 I ~~.OO u:
--~....-----~--_.....----.--...-------......~...._.....
Tlckl 12VOll2 U 00<17 ItJillE lEUIAHNtHAAl1Wi rohll 40.00
01/21/9'J 1-Pl€ASANr IUI lU:R 110 1\tJI'C-tA/1p HIU
012193-0121YJ 99212 - -ESrl\lLhHo1l P 379.23 -VII ~ I 40.00
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02109!V3 I-Flil:'ASAIH lID It:El:R IIll ri[K-CMI' HILL
020W3-0~'0993 - -N/C 1l+ICl VI 379.23 -VIT HUUlfdWJ I 0.00
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Tick' 13048/ U 0007 t<<LLE
02/18!V3 1-t1iWAln"O WEBER HU
011893-02IW3 99213 - -r:SIABLhHoU P JbM~ -Pi.ll
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..-..-............-........-........-...........--........................................................................
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03/25193 I +lEASt\NI IIll lIEP~H"O
OJ25?3-03'~?3 Y\r~13 - -~SIABLIShEO P 362.02 -~i.ll
.00 I .00 I .00 I .00 I .00 I
GI:lWVfHHAATMN Tolill ~0.00
.0,>t;-c,W' HILL
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04/01/93 5-SUIVl "0 WEBEH HD R\K-CA/1P HILL
040193-040193 'l'J'llJ - -r:'lTt\BLI!ilt:O P 362.vl -PUll I 50.00
040193-040193 - -AULt. OX 379..3 -Vll HlI111lldWl 1 0.00
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.........---.....-........-...............................---.........-.................
Tick. 1:ll940 U ??oo NOELLE GElW'lfHHAAII1AN lotall .00
04/05!V3 l-I'HEHSANr"D ~ HO k\Jl'C-U\IlI' H1U
040593-04u:m - -N/e lFHCl: 'II J79.23 -VIr ttilllAAWtll 1 0.00
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~.....----......_.._...._..~......_.--.._...............--_........~............................"".........
Tickl 133474 U 0053 taLU Gl:m\NNIHM1HAH Tolall 40.00
04/23193 I-PlEASANT 110 WEOOlI1O ~C-CAll' HILL
042'J93-04m3 99212 - -ESII\lLISIU P 37?~'3 -VIT Hl:101IlHAll I 40.00
042'J93-0423YJ - -AJn. OX 362.02 -Pi.ll I 0.00
.00 I .00 I .00 I .00 I .00 I .00 I 40.00 UN
......_.~......._.--_...._....._...._.....................................,................_......__......~~......
Tlckl 134540 U ??oo t<<E.1.E Gl:Id1ANHlHARTlIAH lotill .00
(fj/05193 I-PI""SANT HD WEWll10 HIIPNAII' HIU
050593-0~93 - -N/C CfF1LlO VI 379.~'3 -Vll HOOlIlHAO I
o:10593~YJ - -Mil. OX 362.02 -PM I
.00 I .00 I .00 I .00 I .00 I .00 I
0.00
0.00
.00 III
________....OONM.................._........................._...............~...............................................
Tlckl 135347 U 0053 t<<E.1.E
05/19193 1-Ptt:ASANr I1Il WEWlI10
05lm-Q:l19'l3 - -f\tSOI:IlU
.00 I .00 I .00 I
GlktIAIftllWHHAH TaU II .00
kOPC-CAII' HIU
379.23 -VIT H~HORfrtlAU I 0.00
.00 I .00 I .00 I .00 UN
........-......-.............................................................-
Tick' 13:S543 U 00:13 t<<LLE
05120/93 3-PfiENSKl IUI \tiER 110
052Q93-052093 - -HiSOt:'llU
.00 I .00 I .00 I
lElIWfll HAA1HAH T Olill .00
RlJ'C-UlI'I' HIU
379.23 -VlI ft:IIORRIWl I 0.00
.00 I .00 I .00 I .00 UN
.......__............._........_...._.........._....__..__.._..........h__..~......................................~
Tlckl 135703 U 0027 t<<E.1.E GEk11AlfHHAAlHAN lolill 50.00
0:5125193 I-PlEASIVlT HD WEOOl HD HOfC-CAIf' HIU
0525?3-052593 99213 - -~SrI\lLISIU P 379.23 -VIT HUUlRIWJ I 50.00
0:5~rJ-~2:iV3 m~ - -FlJlroJ I'IfJIOS J79.n -VIT H:I1OARHAO I 0.00
.00 I .00 I .00 I .00 I .00 I 10.00 I ~O.oo III
.........._.....---..........................~.............._.......-..................................................
Tlckl 136O'n U 0007 taW.
liERIlANNIHMl1WI Tohll 40.00
06/01/93 \-PlEASANI I1D IIEWl ~
. 060l93-060193. wm . - 'ESTAll.ISlt:Il P 379.aJ
.00 I .00 / .00 I .00 I
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~..__~~______N_____._.._."".._.._..__....."...__._
Tick' 137179 U 00:i3 taLU: liERIWflllWlllIAN Toull ~o.oo
! 06/18/93 1-11I::ASAN1 lID 1I:1lIJl"0 RIK'CMP HILL
I 061893-0618'/3 Wll3 . -ESTABLlliH:O P ~79.z.J -VIT ~ I
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I 061893-061893 . -ADOL OX 362.02 -Plfl 1 0.00
I .00 I .00 I .00 I .00 I .00 I ::0.00 I ~.OO UH
,
,
i Tick' l37~99 U ??oo MlEU.E IlolIlWfllHAH11IAN ToUl1 ~.OO
i 06130/93 I-PtEASAHT"D 1I:Bt:R"0 HlK'U\Itf' HIU
I
! 1l63\m-0630'/3 'N113 - -r:STAll.I>lt:ll P 362.0l -Pill I
! 0631m-~3 n.~ - -IVfA 36~.02 -Pill 1
i 070ll93- -BLUE CROS./IlLUE liHI-01~r.i9VI-N-N'P reJected
! 070893- -CAPITAL IlLUE Cll1lSli -Om~99"~-N-N-P rejolcteu
.00 I .00 I .00 I .00 / .1)() I .W I ~53.00 l.f
50.00
---.----~..--............--...--..--.....~..........--.........
~IOO
::03.00
I _~__...____..__.....__...........__........................__................
Tick' l37863 U ??oo NlIOL.Lt 1:i:RIW.WWlIHAN fatal I 53.00
i 06/30193 1-11t:A!;AN1 IIlJ lIl:fltH HO h\J1:-(:J\I'f HilL
063093-06J0~3 92.:50 - -fUNllLI'3 I1'OTDS :Jb2.o-l 'PDH I 53.00
070893- -BLUE ORU)S/tilUE SHI-0137ij631-Y-N-P rejectea
070893- -CAPITAL BLUE UROtiS -01J/8b32-A'N-P rejected
53.00 I .00 I .00 I .00 I .00 I .00 I :>l.00 l.f
.. ~~__..__........~......__.............__...kN........."..........~...
Tick' 13ll1l50 U ??oo t<<LIL GEIil4ANNllWllMlVlloUIl :JO.oo
07/0719~ 1-I'Hl:ASANT lID Wl:BtR HD HllPc-l;.'Vf' HILL
070793-070793 99213 - -ES1ABLI6I'loIl P 362.02 -PM I 50.00
, 070793'0701V3 - -MOL OX J79.~3 'VIT 1tilOR~ 1 0.00
070T9'J-070193 - -AlJOL DX 362.83 -HIW..AIl EW1A I 0.00
.00 I .00 I .00 I .00 I .00 I .00 I :\1.00 UH
------..-.......-.......---..--........-....................................-.....
Tick' 1311221 U OOll t<<LIL liIoRIWfHf01R11IAN [au II 1,b8b.00
01/01/93 H1t:ASANT"D WEIlIJl HD ROPNJlIt' HILL
070793-070793 67110 - -PHDrOOlAll oD 342.02 'PUH I 1..ij6.00
070ll93- -tillt CRllSS/lA.lI:: E>lU-OI38:'-LlI-N-N-P cleired
010~J- -CAPITAL SLUE CROSS -ul38<1IL-N-N-P rejected
.00 I 1600.00 I .00 I .00 I .00 I .00 / 86.00 Ul'
. ...~__N~N~_N~........__"._______~_N.________NN_.___________~-~~-_....._.
Tick. 1394~1 U 0053 NOEW. GEl11lAlfHHAR1HIVl Totall .00
. 08/10193 I-Flt:ASANT lID IIEEER NO IdlPc-l;AIfl HILL
081093-001093 - -CAIm.1.EIJ ri1' 362.02 -Pill I 0.00
.00 I .00 I .00 I .00 I .00 I .00 I .00 UH
....~.*---..~---...~...~......---...---.....~...--.................
Tick' 140026 U 0027 tmI.E
08/18193 I-PHEASANI lID ~BI:l1 HO
OOIB93-OllIll'f.l '/9113 - -tsTAll.ltiIlt1l P J62.02 -~J)l
.00 I .00 I .00 I .00 I .00 I
Iil:RIWflIHMIIIAN Totill 50,00
h1ll'C-CMP HILL
1 50.00
.00 I 50.00 1II
...........~.............................................._...........
Tick' 140344 U ??oo mLE GlJiI1ANNlHARTNAN lolall .00
08/23/93 I-Plt:ASANI lID WEBl:R"0 Rll'NA/'f HILL
082393-08i:193 - -N/C oHICl VI 379.~'3 -VIT If.IIlRI<IWl I 0.00
.00 I .00 I .00 / .00 I .00 I .00 / .00 UH
.--.----.._~...................~..........................--...--..
Tick' 140526 U 0007 mu: ll:Rl1AlfWiAHIMN ToUll .00
'08125/93 I-PH:ASANI HU lIEBl:R"U HfK-CA/f' HILL
0ll2593-o&2'.1YJ - -N/e IlFFIC~ VI 379.23 -VIT tUlRJilWj 1
082593-08:1593 . -/IDOL OX 362.0l -Pill 1
.00 I .00 I .00 I .00 I .00 I .00 I
0.00
0.00
.00 UH
..----..~....~.---....---.~............--...---.---....---.~.
Tick' 140918 U 0001 IOO.I.E
liERIWfllHARllIAN Toull
.00
09103/93 '-Hl:ASIVlT lID IrIl:llER lID
ovo:m.mm. . .N/e lHla: VI 3/9.23
.00 I .00 I .00 I .00 I
HlJi'C.CM' HIU
.W 1UlIlRl'J\U I 0.00
.00'1 .00 I .00 lJl
___~~_~_~~___"_______~___._._............~..................__.N.
Tlckl 141049 U 0021 tatll GffiIIAIflll'AAll'oAN Totill 3,~6', .00
O9I03/9'J I.PltOASIVlT lID loEBER NO '11102193 09/0l/93 CIHiSH
0902Y3.0'>'02'J3 6"036 .~O.PI'V-DS 319.~3 -VIT ~l\(J(f\HA(j I 3,267.00
09079J- -8LUO CHa3S/BLUE SHI-014104~I-N'N'P reJected
090793- .CAPITAI. BLlI: CRlJS!j -01410492-N-N.P reJected
.00 I .00 I .00 I .00 I .00 I .00 I :U67,oo l.l'
~.----~.--....~--....------.~............--...--..---......--....
Tick' 1411b7 U 0000 tmU: GERlIl\ltUH.OJlINAN Totdl .00
09/10/93 1-11iI:A!iAN1 NU ~Bffi lID hU'(;-CAI1P HilL
091093-'111093 99024 . -H/C POST Ii' V 362.02 .Plll I 0.00
.00 I .00 I .00 I .00 I .\lO I .00 I .00 lJl
..-..-...................-..-..............-...........-.................................-..................................................
Tickl 141770 U 0001 IllELU; lJEIiIIANNlHAR111AN lotall .00
09120m 1-l'Hl'tlSIVlIIIO ~BER NO i1Ol'NI\IIP HILL
Q920V3-0nO'lJ 990:4 - .N/C PiM lP V 362.0. .POIl 1 0.00
.00 I .00 I .00 I ,00 I .\lO I .00 / .00 UN
....--....................................-..............................................................................................-.
Tick' 142267 U ??oo tmLE GERI',WHHARII1AN lotall .00
09129/93 1-f'HEA!iANf liD ~BER IIU Rlll'C.CAI1P HIU
092ll93-ovm3 99U24 - .N/C fthlT UP V Jb2.Ul -PUll I
092893-0'128'13 - .AUlX. OX 379...'3 -VIT HI:lIORl<HAU 1
.00 / .00 I .00 I .00 I .00 I .00 I
0.00
0.00
.00 UIl
--..-....-....-....-...-..........................................-.......................-........-...-...........-....
Tick' 142:i41 U 0053 tmLlO ~IHAAI~AN lotill .00
10101193 I.PHliASIVlI lID WI:IlEH no RIJI'C.CAIIP HIU
100793-100/93 99024 - -N/C PGST l:l' V 36M2 .POH I 0.00
.00 I .00 I .00 I .OU I .00 I .00 I .00 lJl
..-.....-..............-................................................................-......-..........................-......-........
Tick' 14341N U 00:>3 NOEI.I.lo GERllANNIHARII1AN Totall .00
10121193 H'HcASAHT NO \6CR NO HDt'C.CAI'I' HILL
102193-10~lY3 99024 - .N/C POST [J> V 362.02 .PLll I 0.00
.00 I .00 I .00 I .00 I .00 I ,00 I .00 11l
~.........~......_~---~---..............................................................~...............-....
Tick. 144065 U OM MlElLE lil:RItAI\'ilHARl11AN Toull J,~b7.00
10/28/93 I.PHliA5ANT no weBEH 110 OY/27/Y3 09127193 OH.HSH
092793-09219367036 -79-PPV 00 J79.23 .VIr ft:11OI1flHAO 1 3,:67.00
110193- -BLUE CROSS/BLUE SHI.OI440b~I.N.N.P rejected
110193- .CAPITAI. Il.lE I:li1l:iS -01441lb:i2-N.N.P reJected
.00 I .00 I .00 I .00 I .00 I .00 I 3;:67.00 U-
------....-.._...._.._........__......_.._.........._..~..................................................................
TiCk' 143139 U ~ NOEW: GI:HIlANHIHARINAN Totdl :J3.00
1I/0~m Hlt:~T lID ~M 110 I1lll'C.CAIf' H1U
1I~93'1I0593 92:.~ - .fOOlJS PHOTOS 362.02 .PlnI I 5~.00
110893- .BLUE CROSS/BLUE SHI-01431391-N-N.P reJected
110893- -CPPlTAL BLUE CRUSS -0143739~.N-N-P reJected
.00 I .00 I .00 I ,00 I .00 I .00 I 53,00 u:
................~................~........._......_......_..............H..____..__.._................_....
Tick' 145690 U 00~7 t.IlElll IlRlIAIfHHARINIVl Tot"l .00
12/08/93 I.PHEASANT no Wt:Wl 110 RlJPC-CAI'I' HIU
120893-I201l93 99024 - .N/C POST lli' V 3b2.UI -BtJIl I 0.00
.00 I .00 I .00 I ,00 I .00 I .00 I .00 lJl
----~........_--.........._............................................_..............-............................................
Tick. 1469:19 U ??oo taU.!:
01/12/94 I-PHEASANT no WE90R NO
011294-011294 - .Rl:SOI:Illl
.00 I .00 I .00 I
Gl:klW/NIHARTI1AN fatal 1 .00
ROPC.CAI'I' HIU
362.01 -tim I 0.00
.00 I .00 I .00 I .00 UN
..--.-.....--..-----.......-..-...............-..............-------......-....--
TiCk. 147318 U 0001 NUELLE
01/12/94 1-,oHEASIVlI no IeI:R lID
011294-0112'14 - -ilfSOEW.~
.00 / .00 / .00 /
lSlWfjlHMlt1I\N loull .00
RU1:-CII/1f' HilL
362.01 -&00' 1 0.00
.00 / .00 / .00 / .00 lJj
~...-._____.__._...~...4M..__...~__....~..."..~.........".............
TlcU 1413n U ~ /<<Ell Gl:klIANNlHAR11IAH Tolill .00
01/24/94 I-PHtASIVlT lID WtbER lID HtJPC-C~ HILL
012494-0124V4 - -l:ANCB.LEU AI'!' 36Ml -all'< 1 0,00
.00 / .00 / .00 / .00 / ,00 / .~o I .00 ~
~.---.~---....------~........---...~....~........---..----
Tlckl l:iOl38 U 00~1 MlEU.E
03/02194 I-PHtASANI lID IIoBI:R no
~J0294-0~0294 - -~DULt
.00 / .00 / .00 /
~(HMIIIAH Total I .00
RIJl1:.CAIf' HIU
362.01 -BOIl I 0.00
.00 I .00 / .00 / .00 ~
----....--.........--...--........--.............~............--....----..~....
Tick' 1~714 U ??oo NlEU.f G1:RItANNlHARTI1AH Totall 60.00
04/01194 1-~SIVlT NO IoiEBER NO hOfC-CtJ'I' ~ILL
040794-040794 9M3 - -ESTAIl.I5HtO P 362.01 -Hl.Il I 60.00
I ;;;;~..~;:;~.~~; W;~~.~~;~;:~~;;;~~;.!...~~~.!...~~:~.~~....
I 0029 6 01/01/19 r. 25\101U I
0l/21/94 3OO1-L 400.00 tER 110 rJU l!Al. PO. lAPSE IN
0029 6 OI/OI/1Y r. ~41000
'0l/21/94 3OO1-PHUNltES TO PAl :iOO.oo 8Y tMl Cf FtBI'/4
0029 b 01/01!79 r. ,540m
02/21/94 6OO1-SPOKE iO PT ~DR < LAST TlNE<
0029 6 01/01/79 r. ~4<J97U
04/01/94 llOOl-<IH~ Sl'OY.E 10 PI'. fllUl 16 lHAT SHE
0000 5 01/01/79 r' ~6IYObU
04/01/94 aQOl-nuST TAkE C~T LOAN L 81LL MUST HE PAlO
??oo 5 01/OI/7Y r' Z61Y07U
04/01/94 ~ool-WI1HIN 3o-tol\lS OR Fl.fllIiER ACTllJl WIU
??oo 5 01/01!79 r' Z61WflU
04/01/V4 llOOl-W1LL BE IAKtN/LW
0000 ~ Ol/Olm r. Z6l9011J
09129195 8OO1-Sl:NT 1:iO.OO TO H81lT H)l LEGAL I\CTlllll/l
0029 6 01/01/19 r. 340348U
11/12/91 1004-BlUE SHltLD TDWAHU 10/21/91
0033 4 11/12/91 r' 1I8979U 141.00-
11/25/91 Zool-PAlNENT BLUE CROSS
0033 4 11/.:5/91 c. l02b6YI r' 1~0764U 1,600.00.
01/23/92 2OO1-PAIIENT BLUE CROS1l
0029 0 01/23192 c. 1045961 r. 1200nU 1,600.00-
OI/23/"Z 2999-PAlIENT CAPI1A1. SLl1; CROSS
0029 0 Ollt:JI92 c. 102b6n r' 1~'S078U ~OO,80-
02/10/'il zm-PAlllENr CAPI1A1. BlUE CR\J~
0029 12 02/IOrr~ c. 104Sm r' 136607U 500.80-
04123/92 2OO1-PAYNENT BLUE CROSS
0029 12 04/23/9'l. c. 1080001 r. 150537U I,boo.oo-
08/311'il 2ool-PAIIENT BLUE 0lO5:i
0029 1 00/31/92 c. 1lb6941 r' 16981lU 1,600,00-
08/31/92 2'1'19-PAIt1EN1 CAPITAl. Bl.~ lJlOSS
0029 1 00/31/92 c. 1080002 r' 16'/ll12U 372.80-
11/02/92 2m-PAll1ENT Cl\PITAL BLUE CROSS
0029 12 lI/02tn c. 1Ib694~ r' IU0348U 500.00-
02/09/'13 ml-PAllENl BLUE CRtJSlj
0029 12 0~/09193 c. l~b7SYI r' IY4S2SU 1,600,00-
02/18/93 2m-PAltENT CAPITAl. BLUE CROSS
0029 1202/18/93 c. llb75n r' 196imU 586.40-
05m/93 1001-Pl:RSIM. lJ( .1269
i
j 0027 7 f1J/'rJ193 r' ZII46ll1J 10.00-
06/18N3 1001.PI:R LX .1298 .
00:i3 24 06/10/93 r' 21~442U 20.00-
I 07/07/9"3 1001-PER ()( 1330
0029 6 07/07193 r. 2Ie~1l2U 10.00-
08/10/93 2OO1-PAIMENI a.LE CROSS
0029 6 09/19/93 ci 1:J8~1I r' Z~4~14U 1,600.00-
IOBlI8trJ 2OO1-PAII'ENT 8lLE CROSS
0029 b 00/19/93 ci 1~'ll1601 r. 2::4'1I1U 1,641.00-
08/27/93 1001-PER ()( 10135
0029 6 00/27 m ri ~)OIIU 50.00-
fJ912O/9J 1001-Pi:R LX 1417
0029 60'mOm r' 23019~ 50.00-
10/21/9"3 1001-l'tIllX 1m
002'1 b 10121/93 r' 2'J41b5l! 100.00-
l2/oe/9~ 100I-PtJl LX 1537
I 00L? 6 IUoom r. 2429'100 50.00-
I 03/21/94 100Hi:R lX 11>66
0029 6 0~/21/94 r. ~SOloo 400.00-
104/07/94 100l-l'ER ()( 1717 261'IQ~ 60.00-
i ??oo 5 04/07/94 r.
I
i ~/24/94 ~O:JO-R~"l T Ill.l.I:CTIIJi AGENCY HIof~RAAL
i 06/03194 0010 6 OS/24/94 ri 26763bU O,6Ul.40-
2OUI-PAtIENT BLUE CROSS
0021 12 06/03/94 c. mom r. 270132U 0.00
10110194 7001-R1:1NSTAIE BAD lI:IlT/lllIl t ~R()\ RI:IlIT
0010 b 10/10/~4 rl ~1I00 ~-:i.00
, 10/10/94 1010-RI:IlIT CK TO US/PT ~D k1:""
0010 6 10/10/94 r. ~1I9U ~":l.00-
12/30/94 2OO1-PAIHEHr ILLE CROSS
0066 7 12/30/94 c. 1440651 ri 3000WJ 0.00
i 12/30/94 2VV9-D~IEO CAI' IT AI. BLLE UlIlSS
0066 7 12130/94 c. 1440652 r. 30000ru 0.00
12/30/94 200I-PAlIlEhT BLl.E DlOSli
0066 7 1~/30/94 ci 1437391 r. 3000llBU 0.00
12/30/94 Z999-DENIEO CAPITAl. Tt.LE CROSS
0066 7 12/30/94 c' 14373'fl ri 3UOUlm 0.00
12/301V4 ZV99-DtNIED CAl'II AI. BLU: CROSS
0066 7 12130/94 c' 141049'.! r' 3OOiI9OU 0.00
12/30/94 2OO1-PAlttfNT ILLE CROSS
0066 7 12/30/94 c' 1410491 r' 3Ooo91U 0,00
12/30/94 2m-DENIED CAPIIAI. 8lLE CROSS
0066 7 1~/3lJ/94 c' 1332Z1~ r' 3UOOr.dJ 0.00
12/30/94 29'/9-DI,NIED CAPIIAI. Ill.Ue CROSS
0066 7 12/30/94 cl 13786J2 ri 3000930 0.00
. 12/30/94 Z999-DtNIED CAP II AI. BLUE CROSS
0066 7 12/30/94 c' 13159'f2 rl 3U0094U 0.00
12/30/94 2OO1-PAIIlEhT ILUE CROSS
0066 7 IU3O/94 ci 1~75991 r' :JOO<mU 0.00
. 12/30/94 2m-DENIED CAl'ITAI. a.UE CRllll'S
0066 7 12/30/94 cl 1::31602 r' 30009bU 0.00
'12/30/94 2999-DENlfD CAP IT AI. ILLE CROSS
0066 7 12/30/94 c' 11"042 r' 300091U 0.00
12/30/94 2OO1-PAlttfNT IlLUE CROSS
0066 7 12/30/94 ci 1144841 r' 30009W 0.00
CIJIlRENT IlAI.ANCE 0.00
1 now; R MASANT "U 100.00-
5 i:RIC P SlWlI1ll 100.00
3 .MlIGMNSKllUJ 0.00
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7. Denied. After reasonable investigation the Defen-
dant is unable to ascertain whether or not Plaintiff was a
"participating" physician and strict proof thereof is de-
manded at trial. It is specifically denied that Defendant
Terry W. Germann, Jr. was paid directly by the medical
insurer.
8. Denied. As the documents attached to Plaintiff's
Complaint speak for themselves, any attempt to interpret or
characterize same are denied and strict proof thereof is
demanded at trial. By way of further answer, the forms
completed and attached as Exhibit "B" were done at the
request of, and for the benefit of Defendant Noelle J.
Hartman-Germann and not the answering Defendant Terry W.
Germann, Jr.
9.
Denied. It is specifically denied that Defendant
Germann, Jr. received moniea from Blue Cross/Blue
Terry W.
Shield.
10. Denied. It is specifically denied that Defendant
Terry W. Germann, Jr. retained any funds that were rightful-
ly Plaintiff's or benefitted from same. It is further
denied that Plaintiff helped Defendant Terry W. Germann, Jr.
complete the necessary forms by which to received said
reimbursement.
11. Denied. After reasonable investigation the Defen-
dant is unable to ascertain the truthfulness of the aver-
ments set forth in paragraph 11 and strict proof thereof is
demanded at trial.
12. Denied. It is specifically denied that Plaintiff
has sought payment from Defendant Terry W. Germann, Jr.
Further, allegations as to sums due and owing are conclu-
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RETINA & OCULOPLASTIC
CONSULTANTS, P.C.
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
NO, 1996-02516 CIVIL TERM
NOELLE J, HARTMAN-GERMANN and
TERRY W. GERMANN, JR,
Defendants
CIVIL ACTION - LAW
JURY TRIAL DEMANDED
To NOELLE J, HARTMAN-GERMANN
Defendant ( )
been
You are hereby notified th.,!,. on . II r I
/ ~ ' 19~, the fo LOw" g (Judgment)
entered against au in the above-cap oned case,
has
Judoment entered in the amount of $9.6611, 2}
DATE: 7 (1' 7(- ..C J,,: . nl III (
prothOl'lot~y
I hereby certify that the nam~ ~~1r-ess of the proper
person(s) to receive this notice is: ~ 1:]-
NOELLE J. HARTMAN-GERMANN
277 REDWOOD LANE
CARLISLE PA 17013-7818
A NOELLE J, HARTMAN-GERMANN Defendido/a Defendidos/as
Por
este media se Ie esta notificando que el
del 19___, el/la siguiente
sido anotado en contra suya en el caso mencionado en el
de
(Fallo) ha
epigrafe.
FECHA:
protonotario
Certificao que la siguiente direccion es la del defendido/a
segun indicada en el cetificado de residencia:
NOELLE J, HARTMAN-GERMANN
277 REDWOOD LANE
CARLISLE PA 17013-7818
Abogado del Demandante
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IN THE UNITED STATES BANKRUPTCY COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
IN RE: CHAPTER 13
TERRY WILLIAM GERMANN, JR
SHELLEY ANN GERMANN, CASE NO. 1:09-bk-05148
Debtors
TERRY WILLIAM GERMANN, JR,
Movant
v.
RETINA & OCULOPLASTIC
CONSULTANTS PC,
Respondent
ORDER
CERTIFIED F
OM THE RECORD this _//_
, 20 L1/
U
cuu
UPON consideration of the foregoing Motion to Avoid Judgment of Respondent under
Section 522(f) of the Bankruptcy Code , it is hereby
ORDERED AND DECREED that the relief prayed for in the Motion be, and hereby is
granted, to wit, the judgment of RETINA & OCULOPLASTIC CONSULTANTS PC in the
approximate amount of $9,664.20 entered in Cumberland County at docket number # 1.996-25.1.6*
be and hereby is avoided; it is further
ORDERED AND DECREED that a certified copy of this Order may be filed with the
Prothonotary of Cumberland County and the Prothonotary is directed to terminate the judgment
in the judgment indices.
By the Court
Dated: April 22, 2014
Chief Bankruptcy Judge
(OK)
?.si,pc/ c✓6
P0t3a56/46
Case 1:09-bk-05148-MDF Doc 51 Filed 04/22/14 Entered 04/22/14 13:56:49 Desc
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