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HomeMy WebLinkAbout11-7622- V LAW OFFICES OF GEORGE TWARDY, JR. BY: GEORGE TWARDY, JR., ESQUIRE Attorney ID: 52883 1026 Winter Street, Suite 400 Philadelphia, PA 19107-1808 1-877-440-8182 Attorney for Plaintiff "-RLAND COUNT`:' HEi'll HSYLVANIA VALUE HEALTHCARE MANAGEMENT,LLC 152 WEST 57TH STREET NEW YORK NY 10019 CUMBERLAND COUNTY COURT OF COMMON PLEAS V. CIVIL ACTION NO -? ?D uOI ??V t AMY K J WARREN AKA AMY K JOHNSON AND THOMAS W WARREN 112 E RIDGE ST CARLISLE PA 17013 COMPLAINT - CIVIL ACTION NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 Telephone: 717-249-3166 AVISO Le han demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes usted tiene veinte (20) dias de plazo al partir de la fecha de la demanda y la notification. 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 objeciones a las demandas en contra de su medidas y puede decidir a favor del demandante y requiere que usted cumpla con todas las provisiones de esta damanda. Usta puede perder dinero o sus propiedades u otros derechos importantes para usted. "LLEVE ESTA DEMANDA A UN ABODAGO INMEDIATAMENTE SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL." Asociacion De Licenciados De Cumberland County Servico De Referencia E. Informacion Legal Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 Telephone: 717-249-3166 gc1a•oopl CM+ ckk a allb ".2 L SSb I Twardy and Associates, LLC By: George Twardy, Jr., Esquire Identification No. 52883 1026 Winter Street Suite 400 Philadelphia, PA 19107 1-877-440-8182 Attorney for Plaintiff VALUE HEALTHCARE MANAGEMENT, LLC: 152 WEST 57TH STREET NEW YORK NY 10019 VS. AMY K J WARREN AKA AMY K JOHNSON: AND THOMAS W WARREN 112 E RIDGE ST CARLISLE PA 17013 CUMBERLAND COUNTY COURT OF COMMON PLEAS CIVIL ACTION NO COMPLAINT 1. Plaintiff, Value Healthcare Management, LLC, is the Assignee of the debt from Carlisle Regional Medical Center, with offices in CUMBERLAND, Pennsylvania. At all times mentioned herein, Plaintiff is regularly licensed and authorized to do business as a Corporation in the Commonwealth of Pennsylvania. 2. Defendants, AMY K J WARREN and THOMAS W WARREN, are husband and wife and are adult individuals residing at 112 E RIDGE ST, CARLISLE PA 17013. 3. As a result of a certain medical condition, Defendant, AMY K J WARREN, was admitted to Carlisle Regional Medical Center on 01/04/2008 through 01/04/2008. 4. Carlisle Regional Medical Center rendered services to Defendant, AMY K J WARREN, of the kinds and for the prices set forth in their bill which is now part of Plaintiff's records and is set forth as Exhibit P-1. 5. The charges of $2588.06 for Carlisle Regional Medical Center's services were fair, reasonable, and proper charges for the same at the time that they were rendered, and they were agreed to by the Defendants, AMY K J WARREN and THOMAS W WARREN. 6. Said medical care was commensurate with the condition of Defendant, AMY K J WARREN, and was necessary for the health and welfare of Defendant. 7. At or about the time that Defendant received treatment from Carlisle Regional Medical Center, implied, constructive and/or verbal contracts were made between the parties, and Defendants agreed to pay Carlisle Regional Medical Center for the charges of the medical care provided to Defendant by Carlisle Regional Medical Center. 8. On or about 01/04/2008, Defendant, AMY K J WARREN, was discharged from Carlisle Regional Medical Center. 9. At or about the time that treatment was rendered, Defendant, THOMAS W WARREN was the spouse of Defendant,AMY K J WARREN, and is therefore liable for the cost of necessaries furnished to Defendant, AMY K J WARREN. 10. No payments have been made, and Defendants, AMY K J WARREN and THOMAS W WARREN, breached the agreement with Carlisle Regional Medical Center by failing and/or refusing to pay the balance of the agreed price, $2588.06, although requested to do so by Plaintiff and their attorneys. WHEREFORE, Plaintiff demands judgment against Defendants in the amount of $2588.06, plus six percent (6%) interest per annum, from the date of discharge to the date of judgment, and record and non-record costs. TWARDY ND ASSOCIATES BY GEORGE TWARDY, JR., ESQUIRE ATTORNEY FOR PLAINTIFF EXHIBIT P-1 09/06/11 HEALTH MANAGEMENT ASSOCIATES DA04 COID: 858 ACCOUNT #: 7759115 DISCHARGE ACCOUNTS RECEIVABLE RECORD PAT NAME: WARREN, AMY K J ADMIT: 01/04/08 FINANCIAL CLASS: 9 I GAR NAME: WARREN, AMY K J DISCHARGE: 01/04/08 CONTRACT FREQ: S STREET: 112 E RIDGE ST LAST PAY: 01/17/08 MAIL RETURN: ADDR-2: PROGRAM: PAT TYPE: OS CITY: CARLISLE PA 17013 CONTRACT: .00 PAT SEX: F PHONE: (717) 243-6922 COUNTRY: US CURR BAL: .00 GAR SEX: F EMPLOYER: HOMEMAKER TOT CHARGES: 8,157.11 AGENCY CNCL: CSA CODE DATE INSURANCE AGENCY BAL: .00 1: 951 01/17/08 3,466.77- CODE PLAN DATE STAT POLICY NO 2: 200 01/17/08 1,352.28- 1: 200 BC3 01/17/08 8,157 P YWP80085513801 3: 978 11/01/08 3,338.06- 2: 4. 3. 5: LST ACTN: 99 08/06/09 3: ZZ 04/25/08 PAY AUD 1: KK 09/06/08 4: L1 04/22/08 PROCESS REVIEW PAY AUD 2: UU 08/30/08 5: S3 02/11/08 DATE USER DATE EARLYOUT ASSGN: 02/25/08 RETN 04/22/08 REASON 985 08/06/09 PBY454 00/00/00 SOLD A/R $3,338.06 08/06/09 PBY454 00/00/00 I PRIM CD:CSA-UNCOLLECTABLE ; SEC CD:CSA-UNCOLLECTABL 09/09/08 ASST 00/00/00 18:10 is #8 61248 65430 09/07/08 ASET 00/00/00 14:34 lser #999 et T02MFXCR index 1=UP,2=PT,3=GAR,4=INS,5=UB,6=HIS,7=RTN,8=CMTI,9=CMTU,I0=DET,II=LOG, I3=ADJ,ENT=FW 4-9 _ A Sess-1 10.200.98.7 XCAL4105 #§ 2/13 Printed on 09/06/11 13:31:03 09/06/11 HEALTH MANAGEMENT ASSOCIATES DA06 COID: 858 ACCOUNT #: '7759115 GUARANTOR RECORD RESP PARTY: DOB: 01/06/68 PAT NAME: WARREN, AMY K J GAR NAME: WARREN, AMY K J EMPLOYER: HOMEMAKER STREET: 112 E RIDGE ST STREET: ADDR-2: ADDR-2: CITY: CARLISLE PA 17013 CITY: PHONE: (717) 243-6922 COUNTRY: US PHONE: (000) 000-0000 COUNTRY: SSN: 577-82-1915 SEX: F OCCUPATION: RELATIONSHIP TO PATIENT: G OTHER RESP: DOB: 03/12/66 GAR NAME: WARREN, THOMAS W EMPLOYER: PHILLIPS GROUP STREET: 112 E RIDGE ST ADDR-2: CITY: CARLISLE PA 17013 PHONE: (717) 243-6922 COUNTRY: PHONE: (717) 702-5886 SSN: 162-42-9062 SEX: M OCCUPATION: TECH RELATIONSHIP TO PATIENT: S NEXT OF KIN NAME: WARREN, THOMAS CITY: STREET: PHONE: (717) 773-8999 COUNTRY: ADDR-2: RELATIONSHIP TO PATIENT: HSB CELL CMD:I=DAR,2=PAT,4=INS,5=UB,6=HIS,7=RTN,8=CMTI,9=CMTU,10=BAL,II=LOG 4-© A Sess-1 10.200.98.7 XCAL4105 2/13 Printed on 09/06/11 13:31:10 VERIFICATION The undersigned does hereby verify subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities, that he/she is Ezra Zucker, Supervisor of Customer Care of Value Healthcare Management, LLC , plaintiff herein, that he/she is duly authorized to make this Verification, and that the facts set forth in the foregoing Complaint in Civil Action, and any attachments thereto, are true and correct to the best of his/her knowledge, information and belief. Date: /0-3-)o 1i