Loading...
HomeMy WebLinkAbout11-7200U.S. RENAL CARE, INC. f/k/a IN THE COURT OF OMMON PLEAS OF DIALYSIS CORPORATION OF AMERICA CUMBERLAND CO TY, PENNSYLVANIA d/b/a DCA OF CHEVY CHASE, Plaintiff V. Docket No.: //- i 7&iw CAROLYN TERRY, Defendant : Civil Action - Law NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims s pages, you must take action within twenty (20) days after the complaint a entering a written appearance personally or by attorney and filing in writ defenses or objections to the claims set forth against you. You are warner the case may proceed without you and a judgment may be entered against further notice for any money claimed in the complaint or for any other clai Plaintiff. You may lose money or property or other rights important to you ;t forth in the following id notice are served, by ing with the court your that if you fail to do so ,ou by the court without m or relief requested by YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ON E. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO O TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN ET LEGAL HELP. LAWYER REFERRAL SERVICE Cumberland County Bar Association 32 S. Bedford St. Carlisle, PA 17013 (800) 990-9108 C-- _" I --A FTI IN) 70 L9 C, ed? iC? ?3.Sq.6 AVISO Le han demandado a usted en la corte. Si usted quiere defenderse de stas de estas demandas expuestas an las paginas signientes, usted tiene veinte (20) dias de plazo partir de is fecha de la demanda y is notificacion. Hace falta asentar una comparencia escrita',o en persona o con un abogado y entregar a la corte en forma escrita sus defensas o sus objeci' nes a las demandas en contra de su persona. Sea avisado que si usted no se defiende, le corte mara medidas y puede continuar la demanda en contra suya sin previo aviso o notificacion. demas, la corte puede decidir a favor del demandante y requiere que usted cumpla con todas las provisions de esta demanda. Usted puede perder dinero o sus propiedades u ostros derechos i portantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO INMEDIATAME TE, SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PA R TAL SERVICIO. VAYA EN PERSONA O LLAME POR TELEFONO A L' OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVE IGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. LAWYER REFERRAL SERVICE Cumberland County Bar Association 32 S. Bedford St. Carlisle, PA 17013 (800) 990-9108 Date: ?? 1l Respectfully submi CAPOZZI & ASSOCIATES. P Pa. I.D. Y 86341 2933 North Front Stri Harrisburg, PA 1711 (717) 233-4101 Attorneys for Plaintif uire U.S. RENAL CARE, INC. f/k/a DIALYSIS CORPORATION OF AMERICA d/b/a DCA OF CHEVY CHASE, Plaintiff V. IN THE COURT OF CUMBERLAND CO Docket No.: CAROLYN TERRY, Defendant Civil Action - Law COMPLAINT POMMON PLEAS OF TY, PENNSYLVANIA NOW COMES, U.S. Renal Care, Inc. f/k/a Dialysis Corporation ?f America d/b/a DCA of Chevy Chase ("U.S. Renal Care"), by and through its attorneys, and makes the following Complaint for a money judgment against thereof, respectfully avers as follows: 1. Plaintiff, U.S. Renal Care, is a registered Pennsylvania limited having its principal place of business at Camp Hill, Cumberland County, 2. Defendant, Carolyn Terry ("Patient" or "Defendant") is an known address at 5143 Nebraska Avenue NW, Washington, DC, 20008. 3. The clinic formerly known as DCA of Chevy Chase is an & Associates, P.C., and in support ility corporation lvania. individual with a last subsidiary of U.S. Renal Care with a dialysis clinic located at 3 Bethesda Metro Ctr, Ste B-005, Bethesda, MD 20814. 4. U.S. Renal Care provides dialysis treatments and services to itJ patients. 5. On or about April 4, 2007, Defendant executed a Consent for Agreement ("Consent Agreement") to allow Defendant to receive regular from U.S. Renal Care as scheduled by her physician and U.S. Renal Care. copy of the Consent Agreement is attached hereto and incorporated (emodialysis Dialysis treatments A true and correct las 1 Exhibit "A." 6. On or about April 4, 2007, Defendant executed a Patient A Authorization of Payment of Insurance Benefits Agreement (" Agreement"), which required the Defendant to assign and forward ins received for the dialysis treatments from U.S. Renal Care. A true and Assignment and Authorization Agreement is attached hereto and Exhibit "B." 7. Paragraph 1 of the Assignment and Authorization Agr( Defendant "hereby assigns, transfers and sets over to U.S. Renal Care and and Authorization benefits that she copy of the herein as provides that and/or benefits to which the Patient is (or may be) entitled from any insurance ... provider, ..as well as any others who may be financially liable for the Patient's dialysis treatments and se ices and related medical care by and/or at U.S. Renal Care, including health insurance Patient is entitled, to cover the costs of dialysis treatment and services . . previously identified and incorporated herein. 8. Paragraph 2 of the Assignment and Authorization Agreen Defendant "hereby authorizes and directs that payment of all insurance b charges and costs incurred as a result of dialysis treatments and related provided to the Patient by and/or at U.S. Renal Care, be paid and remitted Care...." See Exhibit "B" as previously identified and incorporated 9. Paragraph 3 of the Assignment and Authorization is ... for which the See Exhibit "B" as provides that ..relating to any ices and medical care to U.S. Renal provides that Defendant "hereby acknowledges that the monies or benefits to be paid b the Patient's insurance provider ... for the charges, costs and fees incurred by U.S. Re al Care in its provision of dialysis treatments and related services and medical care to t Patient is and shall at 2 all times remain, the property of U.S. Renal Care...." See Exhibit "B" al previously identified and incorporated herein. 10. Paragraph 3 of the Assignment and Authorization Agreement (further provides that Defendant "hereby covenants and agrees that in the event that any payme?t of insurance benefits ... is sent to the Patient ...that the [Defendant] will promptly and unconditionally forward such payment directly to U.S. Renal Care." [emphasis added] See Exhibit "B" ?'as previously identified and incorporated herein. 11. Paragraph 5 of the Assignment and Authorization Agreement provides that Defendant "hereby acknowledges that, notwithstanding the foregoing assignment and authorization of benefit payments to U.S. Renal Care, the Patient shall be responsible for any and all charges and costs billed by U.S. Renal Care for dialysis treatments anI:I related services ... and that U.S. Renal Care is authorized to bill the Patient directly for payment of such charges and costs." See Exhibit B" as previously identified and incorporated herd 12. U.S. Renal Care, at the special insistence and request of Defendant, during the period of April 2, 2008, through April 30, 2008, ("Dates of Service"), provided numerous separate dialysis treatments ("Dialysis") at the rates and on the dates set forth in U.IIS. Renal Care's business records ("Account Statement"). A true and correct copy of the Account Statement is attached hereto and incorporated herein as Exhibit "C." 13. On January 22, 2010, and May 18, 2010, U.S. Renal Care's counsel mailed to Defendant demand letters, which provided information on how to pay the debt owed to U.S. Renal Care. A true and correct copy of said demand letters are attached h?reto and incorporated herein as Exhibit "D." 3 COUNT I - BREACH OF CONTRACT 14. Paragraphs 1 through 13 are incorporated herein by 15. The rates and total charges set forth in the Account and are the rates that Defendant agreed to pay for the Dialysis. 16. Under the terms of Defendant's policy with her insurance Defendant received a monthly check from CareFirst pursuant to the Care. 17. Defendant's insurance provider did not pay 100% of U.S. which resulted in Defendant owing a co-pay to U.S. Renal Care ("Co- 18. Pursuant to the Assignment and Authorization Agreement, to transfer the payments she received from CareFirst directly to U.S. basis. See Exhibit "B" as previously identified and incorporated herein. Just and reasonable ider, CareFirst, filed by U.S. Renal C'are's claims, was required Care on a monthly 19. The amount that Defendant received from CareFirst, pursuant to the claims submitted by U.S. Renal Care, are indicated in the "Amount Paid" col 20. As provided from CareFirst's records, Defendant received a from CareFirst for the Dialysis treatments during the Dates of Service. 21. Defendant failed to transfer the insurance checks, that she for the Dialysis treatments, to U.S. Renal Care. 22. The total amount of principal that has become due and owing Renal Care, as a result of her failure to transfer all insurance payments failure to pay her Co-pay, is $14,447.64. 23. To date, Defendant has failed and refused to pay the total under the Account Statement and the Assignment and Authorization of $14,447.64. ived from CareFirst Defendant to U.S. she received, and her t due, as provided 4 24. U.S. Renal Care has been financially damaged in the amount Of $14,447.64, plus interest and costs of collection. 25. Defendant's failure to pay her Co-pay, her failure to transfer t?e insurance payments, and her failure to cure her default with U.S. Renal Care, pursuant to the Assignment and Authorization Agreement referenced above, constitute a breach of WHEREFORE, Plaintiff, U.S. Renal Care, Inc., f/k/a Dialysis d/b/a DCA of Chevy Chase, demands judgment against Defendant in the plus interest at the legal rate of 6% per annum from the date of the j OUNT II - ion of America of $14,447.64, CHMENT If this Honorable Court should find that an express contract did no? exist between U.S. Renal Care and Defendant, which is denied, then, in that event, U.S. Rena Care pleads the following alternative cause of action in quantum meruit against the 26. U.S. Renal Care incorporates paragraphs 1 through 25 of t4is Complaint as if set forth at length herein. 27. Having requested U.S. Renal Care to provide the dialysis Care having done so to the benefit of Defendant, Defendant became the just and reasonable charges for the Dialysis. 28. The Defendant has been unjustly enriched by accepting the making full payment to U.S. Renal Care for said Dialysis. 29. The rates reflected in the Account Statement are the just and dialysis treatments and services. See Exhibit "C" as previously identified herein. and U.S. Renal to U.S. Renal Care for and not rates for incorporated 5 30. The total value by which Defendant has become enriched, $14,447.64. See Exhibit "C" as previously identified and incorporated 31. U.S. Renal Care has demanded Defendant pay this amount, to do so. to the Dialysis is Defendant has failed 32. To date, the Defendant has not paid the total amount due to UJIS. Renal Care. WHEREFORE, Plaintiff, U.S. Renal Care, Inc., f/k/a Dialysis Corporation of America d/b/a DCA of Chevy Chase, demands judgment against Defendant in the 4mount of $14,447.64, plus interest at the legal rate of 6% per annum from the date of judgment. COUNT III -CONVERSION OF MONEY 33. U.S. Renal Care incorporates Paragraphs 1 through 32 of this Complaint as if set forth herein. 34. Defendant was aware that due to the contractual relationship *tween Defendant and U.S. Renal Care, pursuant to the Assignment and Authorization Agreeme*t, the insurance payments Defendant received from CareFirst properly belonged to U.S. R?nal Care. See Exhibit "B" as previously identified and incorporated herein. 35. Defendant had a legal and contractual duty to safeguard and f?rward the insurance payments by CareFirst, made payable to Defendant, to reimburse U.S. Renal Care for the Dialysis it provided to her. 36. During the Dates of Service, Defendant's insurance provider paid to her the amount of $14,447.64. 37. Defendant intentionally and permanently retained possession of the monies owed to U.S. Renal Care, by failing to transfer a total of $14,447.64 of the insuran4e benefits CareFirst paid to her, as required under the Assignment and Authorization 6 38. Defendant's intentional possession of, and her failure to insurance monies to U.S. Renal Care for the Dialysis provided to Df conversion. 39. U.S. Renal Care has been financially damaged by Defendant'; amount of at least $14,447.64. WHEREFORE, Plaintiff, U.S. Renal Care, Inc., f/k/a Dialysis Cc d/b/a DCA of Chevy Chase, demands judgment against Defendant for cor of $14,447.64, plus interest at the legal rate of 6% per annum from the dal Respectfully su Capozzi & Dated: By: the CareFirst constitutes conversion in the of America in the amount of judgment. P.C. rmiip k-7 arnoiic, squire Attorne .D. No. 86 41 2933 N. Front Street Harrisburg, PA 171110 (717) 233-4101 Attorneys for Plainti 7 U.S. RENAL CARE, INC. f/k/a IN THE COURT OF DIALYSIS CORPORATION OF AMERICA CUMBERLAND CC d/b/a DCA OF CHEVY CHASE, Plaintiff V. CAROLYN TERRY, Defendant Docket No.: Civil Action - Law VERIFICATION I, Joanne Zimmerman, Vice President of Clinical Services, of U.S. LION PLEAS OF , PENNSYLVANIA Care, Inc., owner and operator of DCA of Chevy Chase, do hereby verify under penalties Of perjury and upon personal knowledge that the contents of the foregoing Complaint are tr?e and correct. Date: z rt7?.?y Joanne Zim niirm Vice President of Clin cal Services U.S. Renal Care, Inc. 214 Senate Avenue, S ite :300 Camp Hill, PA 17011 8 i 1 ' v 6 i MW(SIS CORM. DCA OF C CONSRNT'Yi' l r• , TTON OF A] NY CHASE t; t Patient / W ', - ID Number. I A SEA Dal t ( ) L the undersigned patienrr,, ( ) k the undersigned parent or auardian'of the above p 18 years of age or otherwise incapable of consentiaq hereby request and authorize Dr. bV r Y-e-- -and whomever l designate as his or her associate- or assistant to administer to me (or to the al patient) the procedure known as hemodialysis, under such conditions as she by the physician (s) in attendance. I agree to abide by the policiks rules, an established by the above i, amed;Dialysis Unit in carrying- out its hemodialyi It has been explained to me thafhemo tlysis is a procedure used in the cas impairment of failure of kidney function by which certain comp6n nts of th separated by a semi-per:aseable substazsce which permits the passage of can hinders that of others when the blood is circulated through an artificial lddn dialyzer. I understand that th", we diifferent types of equipment coaployed treatment and diffawn types of fifieial•kidneys (dialyzers) used in the pro I ! t r , i I acknowledge that the possible risks acid complicatiims of psis sw limited to leakage of the "zer, c1u4es in,blood pressure and midfvnctia have been explained to me by thb professional personnel of the Diaiysis Uri behalf of myself and/or the shove patient the dialysis treatment with all eon complications. I also understand that say disorder, which afflicts me, can h trcatownt and on myself during the time that I am receiving a dialysis treats fact does not mean that the dialysis treatment had anything to do with the di problem related to this condition. I further consent to the administration of traraf coons of blood or blood components, or any other treatment and testi testing, deemed necessary or desirable in the judgment of the physician (s) i I am aware that the practice of medicine is not an exact science, and I aolmc guarantee, warranty of representation whatsoever has been offered or made on my behalf concerning the rasults of the hemodialysis procedure. Side 47 r Pa ' LaaO G aardiae c _t print Name: ' Date: Witness: i bate: INCA Fom #1049 ' Revived 10100 ET/60 39Vd who is under : or she may we named be determined regulations s program. of patients with blood are n molecules and V, called a br the dialysis as but not of equipment and I accept, on lial risks and ee efforts on my xd but that this vlopnsent of the ich druss, L including IV attendance. edge that no me or anyone EXHIBIT :06 5t' y '! t nIl?Y.'I'SIS COItPosA OF AIHIERY ,.~ AS3ICNMNT Alm AUTI30 Ori PATENT OF 1NSUIUNCE AEPI Fri:/ 0 pAY?M.. t , •Fatuity; ra A o"'f gme f?' " t 6 "'?" patieiot T? ice` ,ssgw L v? , iis7?) 1. AWGMST t : t sab/or beaaft chw of mwanA ' seas ova to DCA oiC,hc or total g?onrta+m a?'• .??{• and, ledlelodsobd spd p g1h01nay jW boaft be ' • CtlOSC. ipuCsadisa? Udd& isma= .'`f' tp cover Im gm by "or at DCA of {?CVY coves for which; floc Paaum ? by aadlar at otba modie?l peyment,a or °?df ly rd m PAW coat o, wy ?; agrvixa .sad •aay other. medical' cm ieidrr DCA of Cbavy Chow- . &UTjg0WATION OF PAYMENT Of INSURANCE BENZ 1ha wdw iced heret)y mdwi=s and dimM that PWmant of all insurance sacbxfinB itdedtcfsTr beadles, if applicable, nlstisg as any cbm" and cogs ia=td as a result of ds tremmmtts and related swam and medioai cam provided to flit Pau= by and/or at DCA of Chas, be paid and ramined dtv* m DCA of Otvy C hm is aocoo*we with Woucoont p:o m to be pmvidod by an ageoc or represeatad" of DCA of ChM Grose. i , if the ar1deasigaod's ir?sureace policy ar pogmta does not provide for maim o in file aame of DCA at Chv4 C ,'the imdadped kwaby ftofu anshc ios> =m ywvidw or ageccy rewnaft for pwmm of the qvhn* 'Donnas paYmea?L in the Paf wx's am and to deliver said psymcat to DC:A of i' M Ct ta* in the insrevotions provided at to be provided by an spent or represeotWve a 3. VELIVERY OF, BENMT PAYMEN'T'S RECEIVED FROM P The w dm*med hereby.. adtad kdga that the make or beaeti?tl to be houranoe provider or gt?venamatt iit cq for the dal m coat fwd fees Guvy Chat is in provblon of .a*w ,taedaww and veLmed selrv w = fit b MA sloth st oflitiatrea reao,ei4 the property of DC4 of Cb?evj? Cho thereof tits Understood ae?by`: covaimb aad agrees that in the event Warmsce benefits, b eWding MQditore beim , wbi* nWc db=dy to flat burred by DCA of Cbny Chen as a ratadt of ids prat ddoa of Asbysit t, serAw and imedkai care to the Poltieat is seat to the Patient or such Patkati f i-fsat or repremab&e, to the cue mW be, lmdvergendy or G&grwim to promptly and araounditlo my forward suet psymmt dirady to DCA of Cbv E[!01 3Jad it moeles or bewfits due es ad bm"m beae5ls to iatne file at is addtees as get CA oRC hM Gala, ofd by the Patfeadt's named by WA of medical em to the N And to ftAusaoe Iwt any $ -q aft of tares. =0 aitd fees sttseayb ssd rebied t dte M&MVud trill Chase. 'ESE EXHIBIT 04/05/2007 09:15 301 522826 PACE 11/13 , zio Z goad '. =a Q ; :UMN Mud -iAA ?na c ' , T ? " 7? •l I? M `? IIA /rM WID-WhIltO M Am OR V! toqi vaom "lam 1r_' -7?. O?.LV/Nt?Qi?'" 10 NtouvauMLI D a :monq IIoAa=Dim vo o0ordutoo vie X1 am ROW.aa Aq 6XOqo q Wgd'?gad e;o gnp?aasa?oau ?a;?-?-?azagin `u?pan8 a sa tatt8!a M no,Cn o Q /v?-j :amacN #?d s '*Aoga C 4ft'omp I UM! 3o RM 03 pabu I ? 3o gold in pm aq Am Pug Mit:q sasodnW .ib; pa okw ur to Pq" sw poz WTI ao g9' lid sing IDWIMSM 3O S.N$WAVd 90 MOLLVZr&ORLnV aNV .limit ,L dd 130 ?doooivgd v vM iia"s ?1Cgsraq pgao!uspun ou { i ? ? ? $3YdO?O.i10Ad '6 G mp iq p?d?a ? ?;o YOQ ,&q vo4wwAw q?m of ?sOMoa VaIXEM st psi min pwN"u '9 jw hum S,I3d8t1ilH ZONdITl1 M 30 .Lt?I UVd d0 AIOLLV2'T?own QAIY ,LN3Wiwissv ,LDt wd SM. X% top* Aam "dw"M KI ' AMnRVJOA3M V s9oo vaf WAV RMP joi AOMM 0aw ov Ni4 04 paxpow S! moo "30 VDQ rntp pda '>yanome mmbd-oa p= *=t*tu!-oo, lal V*Wp V wpwM vecr?rM ',Sstxaleotssaruo8 m todnd Aimd'ptnp wo Aq P[w paxwo o"Maw M PIN MAQd ?qJJ 3a YoQ Aq MM Mw p P= MAN ? ? po vativ M t • ? d Age so3 ?i its d ` 4.7 ti+ ?. Q ow PM . SLN "Vd Wds Air, U SNO4M-M 'S ? •? isnpottr se Tt? a>: s» pasoisu paa sap gone ? 03 P Qq;4--ssMAM jo Voaoslq$w Pmt NOJMP JOWMAVd JD IN oo W 39 " 2 s e ? 2 5 ` am P P p WA .411111d. 4 ?tl !P P 9 ! d ! An o atti. • 4 I-AV mtnWOd:oo . , m as %Mau ai i*! ii °aogeotsoia ,ice p vad m i[a da''sg^,ptq u ao spa SR )o A&& m kwo 3a`Y5Q dq aes&u M as we a?va?ogvte X4 4 PodpM vqL r ! NoLvrtoNi 40 zgvTM 't t '. i ! j I - ,, T Itemized U B04 Statement Facility: DCA-CHEVY CHASE 3 BETHESDA METRO CENTER, SUITE 8005 BETHESDA, MD 208145330 (866) 390-0376 Provider Number: 21ME Insurer: CAREFIRST BC/BS 50 Group Number-.9904 Policy NumberXIP901799103 Claim # 1st 2nd Rev. Description of Service Date ICD9 ICD9 HCPC Code User JSTINE Date: 2/4/09 Page 1 of 1 Billing Quantity Charges Patient: TERRY, CAROLYN D. 5143 NEBRASKA AVENUE NW WASHINGTON, DC 20008 132080-1 041021084W30108 ADMIN SUPPLIES 04/07/08 A4657 270 1 13.85 04/14/08 A4657 270 1 13.85 04/21108 A4657 270 1 13.85 04/28/08 A4657 270 1 13.85 Treatment Item Subto al: 4 $55.40 EPOETIN<10000/100 UNITS 100 UT .04/07108 285.21 Q4081 634 22 192.06 IV 04114/08 285.21 Q4081 634 22 192.06 04/21/08 285.21 Q4081 634 22 192.06 04128/08 285.21 Q4081 634 22 192.06 Treatment Item Subto al: 88 $768.24 HEMODIALYSIS TREATMENT 04/02/08 585.6 90935 821 1 1,048.00 04104/08 585.6 90935 821 1 1,048.00 04/07/08 585.6 90935 821 1 1,048.00 04/09/08 585.6 90935 821 1 1,048.00 04/11/08 585.6 90935 821 1 1,048.00 04/14/08 585.6 90935 821 1 1,048.00 04116/08 585.6 90935 821 1 1,048.00 04/18/08 585.6 90935 821 1 1,048.00 04/21108 585.6 90935 821 1 1,048.00 04/23/08 585.6 90935 821 1 1,048.00 04/25/08 585.6 90935 821 1 1,048.00 04/28/08 585.6 90935 821 1 1,048.00 04/30/08 585.6 90935 821 1 1,048.00 Treatment Item Subto al; 13 $13,624.00 Claim Subto al; 105 $14,447.64 Grand To al: 105 $14,447.64 QMS Focus EXHIBIT G Louis J. Capozzi, Jr., Esquire* Daniel K. Natirboff, Esquire Donald R Reavo, Esquire Bruce G. Baron, Esquire Andrew R. Eisemann, Esquire Michael M. Jerominski, Esquire Dawn L. Richards, Esquire Timothy Ziegler, Reimb. Analyst Karen L. Fisher, Paralegal Jennifer Kain, Paralegal Keyoung Gill, Paralegal (licensed in PA, NJ and MD) ?. (lieemed in PA and MD) January 20, 2010 Carolyn Terry 5143 Nebraska Avenue, NW Washington, DC 20008-2048 Re: Account with Dialysis Corporation of America Account Balance: $14,447.64, plus costs of collection Our Matter No.: 1087-08 Dear Ms. Terry: Please be advised that our law firm represents Dialysis Corporation your delinquent account. Your Payment Agreement with our client is curr( to cure the default or contact me to make payment arrangements, we will p: necessary, against you to obtain asset information, force a settlement, or ob 2933 North Front Street Harrisburg. PA 17110 Telephone: (717) 233-4101 Fax: (717) 233-4103 www.cavozziassociates.com Craig I. Adler, Esq. Of Counsel America regarding ly in default. If you fail ecute a lawsuit, if n a money judgment. You received numerous treatments from our client's facility, and you, health insurance carrier provided checks to you for the specific purpose of reimbursing the Dialysis orporation of America. You have failed, however, to transfer the payments as required by the Provid Agreement. In addition, you have failed to fulfill your obligations pursuant to the Repayme Agreement. When suit is filed it may give rise to the following consequences: 1. To defend this suit, it may be necessary for you to appear 2. If a judgment is obtained against you, you may be require attorney's fees, and interest in addition to the money you 3. If a judgment is obtained against you, a writ of execution the seizure and sale of your personal or real property. 4. A judgment is a matter of public record, and it will negati rating. NOTICE: UNLESS YOU DISPUTE THE VALIDITY OF THIS PORTION THEREOF, WITHIN 30 DAYS AFTER RECEIVING THIS WILL BE CONSIDERED TO BE VALID. IF YOU NOTIFY OUR OF] WITHIN 30 DAYS AFTER RECEIVING THIS NOTICE THAT THIS ] PORTION THEREOF, IS DISPUTED, WE WILL OBTAIN VERIFI0 i court. to pay court costs, )w owe. (ay be issued ordering affect your credit EBT, OR ANY NOTICE, THE DEBT CE IN WRITING EBT, OR ANY TION OF THE DEBT EXHIBIT AND WE WILL MAIL A COPY TO YOU. THE NAME OF THE ORI INAL CREDITOR OF THIS DEBT IS IDENTIFIED ABOVE. 711 THIS LETTER AND ALL OTHER COMMUNICATIONS FRO US ARE ATTEMPTS TO COLLECT A DEBT. ANY INFORMATION OBTA D WILL BE USED FOR THAT PURPOSE. Please make arrangements to pay this debt in one or more installment ayments, or you may call me if you have any other questions. You have the right to consult with attorney for advice regarding this serious matter. I trust that you will give this Notice your imme fate attention. Very truly yours, & A. )"'_ . Michael M. Jerominski MMG/kjg cc: Lisa A. Laudeman, DCA 2 Louis J. Capozzi, Jr., Esquire* Daniel K. Natirboff, Esquire Donald R. Reavey, Esquire Craig 1. dler. Fsquire** Bruce G. Baron, Esquire Andrew R. Eisemann, Esquire Michael M. Jerominski, Esquire Dawn L. Richards. Esquire Timothy Ziegler, Reimb. Analyst Karen L. Fisher, Paralegal Keyoung J. Gill, Paralegal * (Licensed in PA, NJ and MD) ** (Licensed in PA and NJ) May 18, 2010 Carolyn Terry 5143 Nebraska Avenue, NW Washington, DC 20008-2048 Re: Account with Dialysis Corporation of America Account Balance: $14,447.64, plus costs of collection Our Matter No.: 1087-08 Dear Ms. Terry: As you are aware, our law firm represents Dialysis Corporation of above-referenced delinquent account. You have failed to respond to my It 2010, attempting to resolve this matter in an amicable manner. According choice but to advise our client to proceed with civil litigation to obtain a 1v full amount owed, plus interest, attorney's fees, and costs of collection. 2933 North Front Street Harrisburg, PA 17110 Telephone: (717) 233-4101 Facsimile: (717) 233-4103 www.capozziassociates.com Mid-Penn Abstract Company Charter Settlement Company Telephone: (717) 234-3289 Facsimile: (717) 2344670 ?nerica regarding the er, dated January 22, you have left me no ney Judgment for the Please call or write to me immediately if you would rather settle thi matter and make flexible payment arrangements. Otherwise, this will be my final communication to you before we file the civil Complaint to obtain a money judgment for the full amount ow (d, plus costs of collection. Yours truly, llh, A. , Michael M. Jerominski /kjg cc: Lisa A. Laudeman U.S. RENAL CARE, INC. a DIALYSIS CORPORATION OF AMERICA d/b/a DCA OF CHEVY CHASE, Plaintiff V. CAROLYN TERRY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : Docket No.: 11-7200 Civil Action - Law PRAECIPE TO ENTER RETURN OF SERVICE TO THE PROTHONOTARY/CLERK OF SAID COURT: Kindly enter as a matter of record the attached Affidavit of Service form as proof of personal service of the above-referenced Complaint upon the Defendant Carolyn Terry at 5143 Nebraska Avenue, NW, Washington, DC 20008. A competent adult served the Complaint in accordance with Pa.R.C.P. No. 402(a) on October 23, 2011. Dated: 11 f t Philip C. Wgholic, Esquire Attorney I. No.: 86341 Capozzi & Associates, P.C. 2933 N. Front Street Harrisburg, PA 17110 (717) 233-4101 Attorney for Plaintiff U.S. RENAL CARE, INC F/K/A DIALYSIS CORPORATION OF AMERICA D/B/A DCA OF CHEVY CHASE Plaintiff VS. CAROLYN TERRY Defendant person to be served (Name and Address): CAROLYN TERRY 5143 NEBRASKA AVE, NW WASHINGTON DC 20008 By serving. CAROLYN TERRY Attorney: PHILIP C WARHOLIC, ESQ Papers Served: NOTICE TO DEFEND, COMPLAINT, EXHIBITS Service Data: "4rved Successfully [ j Not Served Date/Time: 1Q I'2 1/ 1 \ ,T, V6elivered a copy to him/her personally ( j Left a copy with a competent household member over 14 years of age residing therein (indicate name & relationship at right) ( j Left a copy with a person authorized to accept service, e.g. managing agent, registered agent, etc. (indicate name & official title at right) L( nr'?&i/ Court Of eZI77177017 fJ? u?1 Venue Docket Number: 11 7200 AFFIDAVIT OF SERVICE (For Use by Private Service) Cost of Service pursuant to R. 4:4-3(c) Attempts: Date/Time: 101,20 Date/Time: -L 3 -1 y , 2- Date/Time: Name of Person served and relationship/tMe: Description of Person Accepting Service: SEX: F AGE: ?F HEIGHT: S1 -7 WEIGHT: SKIN: HAIR: OTHER: NI/J Unserved: [ } Defendant is unknown at the address furnished by the attorney ( j All reasonable inquiries suggest defendant moved to an undetermined address j ] No such street in municipality (j Defendant is evading service ( j No response on: DateTme: DateTme: Date/Time: Other: served Data: Subscribed and Sworn to me this ? 20day of Notary Signature: X65 [-> Z 0/3? Name of Notary Commission Expiration I, ,A ffz&kc. ?1r i?,rf was at the time of service a competent adult, over the age of 18 and not having a direct interest in the litigation. I declare under penalty of perjury that the to ing is true and correct. e-Y/20_.LL Sign o Process Server Date JS?' U.S. RENAL CARE, INC. f/k/a IN THE COURT OF COMMON PLEAS OF DIALYSIS CORPORATION OF AMERICA CUMBERLAND COUNTY, PENNSYLVANIA d/b/a DCA OF CHEVY CHASE, Plaintiff V. : Docket No.: 11-7200 CAROLYN TERRY, Defendant : Civil Action - Law ORDER V? ?r--- AND NOW, THIS 7 day of (/ k4 , 2012, upon motion of Plaintiff, IT IS HEREBY QRDERED that Defendant Carolyn Terry shall answer fully Plaintiff's Post- Judgment Interrogatories within ten (10) days hereof, under penalty of further sanctions, as follows: f'?GGt•j??t? f.??/' &o-"-_ 04C."-- BY THE COURT: J. f`) ed p e ` z i 9' ?5?%a S "f ?a ?© /yh `Tr ?y 4 ?G